Adult transgender care: A review for urologists
Bibliographic record
Abstract
male at birth but who identify as female will be referred to as 'transgender women'.It is important for a health care provider to inquire what pronouns patients' use to ensure the appropriate language is used and to establish trust.Pronouns can include "she/her", "he/him", "they/them" and others.Terminology is ever changing.Staying current on trans competent language may lead to improved patient care. The transition processGender dysphoria/ incongruence is defined as distress that may accompany the incongruence between one's gender identity and one's assigned sex at birth.(5)Transition is a term used to describe the process one might take to express their felt gender identity.Transition may involve, social, medical or surgical elements.Social transition can include aspects such dressing in clothing that reflects their gender identity, name/ pronoun change, and changing government identification.Social transitioning alone may alleviate distress from gender dysphoria with improved quality of life and well-being.( 6) Medical transition generally refers to starting hormone therapies.Surgical transition can include many possible surgeries to alter one's primary and secondary sex characteristics.There is not one way that a TGNB individual transitions.The process is individualized.For many TGNB patients, social, medical and surgical transition can greatly improve gender dysphoria.(7)In Ontario, the TransPULSE study surveyed 433 participants regarding the transition process.(8)Of those surveyed, 30% had not undertaken any steps in the transition process, while 23% were living in their felt gender but without any medical intervention.Forty-six percent of transgender women and 39% of transgender men were currently using hormones for a medical transition.Twenty-three percent reported having completely transitioned, which was self-defined and could include medical or surgical measures.Of surgical interventions, orchiectomy was most common, reported by 21% of transgender women.Vaginoplasty was reported in 15% of transgender women.In contrast, only 0.4 % of transgender men had undergone phalloplasty.The study confirmed this population represents a heterogeneous group in terms of accessing different aspects of transition.This study also suggested that we may be at the 'tip of the iceberg' in terms of the numbers of patients going through this process. Hormonal and medical therapiesMany patients choose to pursue medical treatments to address their gender dysphoria.Hormonal therapy is generally overseen by the patient's primary care provider or endocrinologist.Hormonal modulation has quality of life benefits for transgender patients.(9,10) Criteria for the prescription of hormone therapy includes: gender incongruence, capacity to make informed decisions, and reasonable control of associated mental health conditions.(11)For transgender men, masculinizing hormonal treatment is primarily exogenous testosterone therapy.Transdermal, subcutaneous and intramuscular (IM) formulations are most
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".