Unlike a topical cream meant to act only where it is applied, an estrogen patch delivers hormone across the skin into the bloodstream, bypassing first-pass liver metabolism, by the transdermal route.
Missing Word
transdermal
A transdermal product delivers drug across the skin for absorption into the general circulation, rather than acting only where it is applied. Estradiol patches are one option for feminizing therapy, and because the drug skips first-pass liver metabolism, this route is often chosen for patients with a higher risk of blood clots.
Category: Feminizing Estrogens
Question 2
Testosterone stimulates red blood cell production, so the hematocrit, the share of blood volume made up of red cells, is checked before and during masculinizing therapy.
Missing Word
hematocrit
The hematocrit is the fraction of blood volume occupied by red cells. Testosterone stimulates erythropoiesis, so a rising hematocrit can signal excess red cell production that raises clot risk.
Category: Testosterone Therapy
Question 3
A person whose gender identity matches the sex they were assigned at birth is described as cisgender.
Missing Word
cisgender
Cisgender means that gender identity and sex assigned at birth are congruent. It is the counterpart to transgender, which describes an identity that differs from sex assigned at birth.
Category: Gender Terminology
Question 4
A person born with chromosomes, hormones or reproductive anatomy that do not fit typical male or female patterns is described as intersex, a term with a different meaning from transgender.
Missing Word
intersex
Intersex describes variations in sex traits present from birth, while transgender describes gender identity. An intersex person may be cisgender or transgender.
Category: Gender Terminology
Question 5
Spironolactone and finasteride are used in feminizing therapy because they reduce the effects of androgens, the male sex hormones.
Missing Word
androgens
Androgens are the male sex hormones, chiefly testosterone and dihydrotestosterone. Antiandrogens lessen their effects by blocking their receptors or their activation, which supports feminizing goals.
Category: Antiandrogen Therapy
Question 6
Testosterone increases muscle mass because it is anabolic, meaning it promotes the building of body tissues.
Missing Word
anabolic
An anabolic substance promotes the building of tissue, especially muscle and bone. Testosterone has both anabolic and masculinizing effects, so muscle mass and strength rise during masculinizing therapy and decline if it is stopped.
Category: Testosterone Therapy
Question 7
Testosterone increases oil production by the sebaceous glands, which can cause acne on the face and back.
Missing Word
acne
Acne develops when excess sebum and skin cells block hair follicles. It is a common early effect of testosterone and is managed with skin care or dermatologic treatment.
Category: Testosterone Therapy
Question 8
Testosterone does not reliably prevent pregnancy, so a transgender man with a uterus and ovaries who could become pregnant needs a reliable method of contraception.
Missing Word
contraception
Contraception is the prevention of pregnancy. Ovulation can still occur on testosterone, and testosterone can harm a developing fetus, so patients who could conceive are counseled on reliable birth control.
Category: Monitoring and Fertility
Question 9
Gender-affirming genital surgery for a transgender woman leaves the prostate in place, so it still needs age-appropriate screening.
Missing Word
prostate
The prostate is not removed during vaginoplasty, so screening follows the organs a person has. Estrogen and androgen suppression make prostate disease less common but do not eliminate it.
Category: Monitoring and Fertility
Question 10
Freezing sperm or eggs before hormone therapy so they can be used later is called cryopreservation.
Missing Word
cryopreservation
Cryopreservation is storage of cells at very low temperature for later use. Because gender-affirming hormones can impair fertility, sperm or egg freezing is discussed before therapy begins.
Category: Monitoring and Fertility
Question 11
The estrogen preferred for feminizing therapy, the most potent estrogen the body makes naturally, is estradiol.
Missing Word
estradiol
Estradiol is the most potent natural estrogen and can be given by mouth, by transdermal patch or by injection. It is preferred over synthetic ethinyl estradiol because of the latter's higher clot risk.
Category: Feminizing Estrogens
Question 12
Referring to a person with gendered words, such as he or she, that do not match their gender identity is called misgendering.
Missing Word
misgendering
Misgendering is using gendered language that does not fit a person's identity. When it happens, the nurse briefly apologizes, corrects the word and continues.
Category: Affirming Communication
Question 13
Feminizing hormone therapy often lowers libido, the drive for sexual activity.
Missing Word
libido
Libido is sexual desire. Estrogen and androgen suppression commonly reduce it, along with spontaneous erections, and patients are told this before therapy so they can make informed choices.
Category: Feminizing Estrogens
Question 14
Testosterone causes growth of the clitoris, an expected and lasting change called clitoromegaly.
Missing Word
clitoromegaly
Clitoromegaly is enlargement of the clitoris. It is an expected masculinizing effect of testosterone that usually persists if therapy is stopped, and discomfort should be reported.
Category: Testosterone Therapy
Question 15
Words such as she, he and they that a person uses to refer to themselves are called pronouns.
Missing Word
pronouns
Pronouns are the words used in place of a person's name. Asking every patient which pronouns they use, and using them, is part of respectful care.
Category: Affirming Communication