624 Obstetrics and Gynecology Board Review •••
❍ Do transgender men need mammograms if they have had a mastectomy?
If the patient has a family history, residual tissue, or risk factors, they will need yearly mammograms. All
transgender men should continue to have annual chest tissue exams.
❍ After a hysterectomy, do transgender men need Pap smears?
Only if they have a history of cervical cancer or high-grade cervical dysplasia. If they had a supracervical
hysterectomy, then pap guidelines should be followed.
❍ What changes will occur in transgender women using estrogen?
Gynecomastia, redistribution of fat, reduced testicular volume, and reduced hair growth.
❍ What should be screened for annually in transgender women on estrogen?
Prolactin levels and visual field examinations to check for prolactinomas.
❍ What are some risk factors that would require a transgender woman to need a mammogram after the age of
50?
BMI >35, estrogen and progesterone use >5 years, and family history.
❍ Are Pap smears needed in a transgender woman with a neovagina?
No.
❍ What medication can be used in transgender children to delay puberty?
Gonadotropin-releasing hormone (GnRH) agonists.
❍ At which tanner stage should GnRH agonists be started in children?
Tanner Stage 2 of puberty.
❍ Is HIV a contraindication for hormone treatment in transgender individuals?
No.
❍ What percentage of women in the United States identify as lesbian?
1.1%.
❍ What percentage of women in the United States identify as bisexual?
3.5%.
❍ What are some risk factors for bacterial vaginosis in women that have intercourse with women?
Higher number of lifetime female partners, shared use of vaginally inserted sex toys, and a female partner with
bacterial vaginosis.