622 Obstetrics and Gynecology Board Review •••
❍ What is the definition of genderqueer?
This refers to someone who defies or does not accept stereotypical gender roles and may choose to live outside
expected gender norms. Genderqueer people may or may not partake in hormonal or surgical treatments.
❍ What does it mean to transition?
Making changes to one’s life in order to live in an affirmed gender. This may include social and/or medical changes
such as changing one’s name, revising legal documents to reflect one’s gender identity, taking hormones, or having
surgery.
❍ Do the majority of transgender people have genital surgery?
No. Not all transgender people desire surgery, and many who do cannot afford them.
❍ In regards to fertility, what is important to discuss prior to initiation of hormone therapy?
Hormone use may reduce fertility and can even cause permanent infertility even if hormones are discontinued.
There is a need for good reproductive counseling.
❍ What can transgender women do prior to hormone therapy if they desire a biological child?
They can utilize sperm banking for potential future use.
❍ What can transgender men do prior to hormone therapy to preserve fertility?
They can freeze their eggs or embryos for future implantation. Those that do not ovulate on their own after
stopping hormone therapy can attempt pregnancy with the eggs or embryos that were preserved prior to treatment.
It is important to recognize that not all transgender men regain fertility.
❍ Are transgender people at a higher risk of acquiring HIV?
Yes, four times the risk is highest in transgender women of color.
❍ Are transgender men on hormones at risk for pregnancy if they have unprotected intercourse with
nontransgender men?
Yes. Even though testosterone reduces their fertility, testosterone is not a form of contraception.
❍ What is the percentage of transgender men who do not receive annual pelvic examinations?
50%.
❍ What are the reasons for transgender men to not receive annual pelvic examinations?
Discomfort with the physical examination, lack of money or insurance, lack of a medical provider that they feel
comfortable with, and the belief that they do not need pelvic examinations.
❍ What are absolute contraindications to androgen therapy?
Pregnancy, breastfeeding, uncontrolled coronary artery disease, active endometrial cancer, active known androgen
sensitive breast cancer