Exam Preview for 1677: Gender Affirming Surgery for Adults: Conduct

Gender Affirming Surgery for Adults: Conducting Readiness Evaluations

Please note: exam questions are subject to change.

1. Which of the following are NOT WPATH SOC 8 guidelines for establishing readiness for gender-affirming surgery? explore impact on reproduction and reproductive options for individuals pursuing gonadectomy diagnose gender incongruence establish capacity for consent ensure that there are no co-existing medical or mental health problems
2. What is a general recommendation for pre-requisite treatment before approving an individual for irreversible gonadectomy? a minimum of 1 year of hormone therapy a minimum of 6 months of hormone therapy a minimum of 3 sessions of mental health treatment a minimum of 6 months of mental health treatment
3. How would you go about using the informed consent model to evaluate readiness for gender-affirming surgery in a patient who has severe depression? There is no need to discuss depression with the patient; if the patient is diagnosed with gender incongruence they are a good candidate for gender affirming surgery. Ensure that the patient is engaged in treatment for depression prior to approving surgery. Patients with severe depression should not be undergoing gender-affirming surgery as doing so would exacerbate their depression. Discuss any possible impacts that surgery might have on the patient’s depression; unless there is a likelihood of significant decompensation with a risk of danger to self or others, depression would not be a contraindication for gender-affirming surgery.
4. Which of the following is NOT a guideline when discussing reproduction with a patient exploring irreversible gonadectomy? Explore reproductive options with the patient. Assess for the patient’s capacity to understand the effect of gonadectomy on reproduction. Ensure that the patient does not plan for future biological children before approving them for gonadectomy. Refer the patient to a fertility specialist if they are interested.
5. How might a therapist consider the role of social transition and social supports with a patient pursuing gender-affirming surgery? Explore with the patient any potential social impacts of gender-affirming surgery and identify social supports to assist with post-operative care. Emphasize the importance of social transition either prior to or during medical transition. Ensure that the patient is connected to trans community and other affirming social supports prior to approving them for gender-affirming surgery. Ensure that the surgery aligns with the social/gendered role that the patient holds in their personal life.
6. How can someone healing from masculinizing top surgery reduce the likelihood of scarring? Reduce postsurgical activity, utilize Vitamin E, and use compression techniques. Reduce postsurgical activity, avoid sun exposure, and use compression techniques. Engage in postsurgical stretches, avoid sun exposure, and use compression techniques. Reduce postsurgical activity, begin massaging the scars immediately after surgery, and consider cover-up tattoos.
7. For which surgery is dilation required for up to a year following the surgery? Metoidioplasty Full-depth vaginoplasty Zero-depth vaginoplasty Hysterectomy
8. What is a substance use concern for individuals pursuing gender-affirming surgery? cigarettes alcohol cannabis edibles psilocybin
9. How would you approach a patient who does not have housing and is pursuing gender-affirming surgery? Inform the patient that having stable housing is a pre-requisite for gender affirming surgery. Work with the patient to identify supports that can assist them with post operative recovery even while they are homeless. There is no need to discuss housing with a patient pursuing gender-affirming surgery. Discuss the importance of having a safe space for post-operative recovery; refer to case management services to access housing.
10. What is one reason that a patient might choose to pursue metoidioplasty rather than phalloplasty? Metoidioplasty never involves surgical intervention. Metoidioplasty has a lower risk of complications and does not require taking skin from a donor site. Metoidioplasty has the same results as phalloplasty with fewer complications. None of the above
11. Based on current research studies, what is the percentage of trans and gender diverse adults who regret gender-affirming surgery? 1% 5% 10% 15%
12. Which of the following best describes the DSM-V criteria for gender dysphoria? Persistent distress related to the incongruence between one's experienced gender and assigned gender. Persistent distress related to a strong desire to be rid of one’s primary/secondary sex characteristics because of incongruence between one’s experienced and assigned gender. Persistent distress related to a desire for the primary/secondary characteristics of another gender. A psychiatric diagnosis applied to anyone who identifies as transgender.
13. What is NOT an overall guideline for writing letters of recommendation for gender-affirming surgery? establish a diagnosis of gender incongruence with functional impairment describe how surgery will reduce distress/functional impairment establish capacity to consent describe how the patient’s comorbid mental health conditions have all been fully and adequately treated
14. What would be a rationale for a patient pursuing orchiectomy without vaginoplasty? The patient wants the presence of a vulva without a vagina as they do not anticipate having receptive penetrative sex. The patient does not want the production of testosterone and does not want or cannot tolerate androgen blockers. The patient is interested in top surgery but not in bottom surgery. The patient is interested in a hysterectomy to reduce gender incongruence associated with menstruation.
15. Which best encapsulates the general theoretical framework of the informed consent model? Healthcare professionals have extensive knowledge of gender incongruence and must determine whether gender-affirming surgery is appropriate for a trans/gender diverse patient. It is the healthcare professional’s responsibility to ensure that trans and gender diverse individuals do not pursue gender-affirming surgery that they might regret in the future. Trans and gender-diverse patients who have the capacity to consent to care should be supported in making their own decisions regarding their transition car The most important focus of gender-affirming care is ensuring that trans and gender-diverse patients do not undergo surgery that may exacerbate their mental health.