| Show Learning Points most relevant to Phase 1: |
Trans- and Gender Diverse Health
| Clinical Discipline(s)/Organ System(s) Endocrinology, General Practice, Paediatrics, Reproduction & Development | Progress Test Topic(s) |
Description
A mother presents to the family doctor with her 14 year old adolescent. They have come out to the whanau as being transgender and has asked to be known by a different name. Mother reports they are really struggling with menstruation and her teenager wants to start testosterone. The adolescent was assigned female at birth). Mother reports they have dressed as a boy since very young, wearing their hair short and has often told their family they really are a boy. The family have been happy for their child to express themselves in a masculine way at home but they are known as a girl at their co-educational school.
Progress Test-Type Questions: Question 1 | Question 2
The young adult and their mother want advice and direction.
Applied Science for Medicine
- Fetal medicine and anatomy of development of reproductive organs
- Endocrinology of puberty
- Cognitive changes associated with puberty
- Fetal medicine and anatomy of development of reproductive organs
- Endocrinology of puberty
- Cognitive changes associated with puberty
Clinical and Communication Skills
- Taking a history from caregiver and from young person (HEADSS assessment)
- Seeing young person alone as a healthcare professional
- Understand and recognise distress that arises from incongruence between a person’s gender identity and their sex assigned at birth (gender dysphoria).
- Use of appropriate terminology in talking with and about trans-children, young people and adults
- Use of respectful and affirming language
- Starting pathway of supportive exploration of the child’s gender identity over time including assessment of family support, dynamics and functioning.
- Developmental assessment including obtaining educational history and social functioning (HEADSS assessment).
- Assessment/detection of any co-existing mental health difficulties
- Knowing the clinically relevant education and referral pathways including to secondary and tertiary services for child with gender dysphoria to a paediatrician or paediatric endocrinologist experienced in the care of trans and gender diverse adolescents for medical assessment (ideally prior to the onset of puberty).
- Inquiring about preferred name and pronoun during consultations
- Taking a history from caregiver and from young person (HEADSS assessment)
- Seeing young person alone as a healthcare professional
- Understand and recognise distress that arises from incongruence between a person’s gender identity and their sex assigned at birth (gender dysphoria).
- Use of appropriate terminology in talking with and about trans-children, young people and adults
- Use of respectful and affirming language
- Starting pathway of supportive exploration of the child’s gender identity over time including assessment of family support, dynamics and functioning.
- Developmental assessment including obtaining educational history and social functioning (HEADSS assessment).
- Assessment/detection of any co-existing mental health difficulties
- Knowing the clinically relevant education and referral pathways including to secondary and tertiary services for child with gender dysphoria to a paediatrician or paediatric endocrinologist experienced in the care of trans and gender diverse adolescents for medical assessment (ideally prior to the onset of puberty).
- Inquiring about preferred name and pronoun during consultations
Personal and Professional Skills
- Understanding own bias
- Understanding own bias
Hauora Māori
- Understand the difficulties in accessing trans and gender diverse healthcare can be more vulnerable in culturally and linguistically diverse groups including Māori
- Understand the difficulties in accessing trans and gender diverse healthcare can be more vulnerable in culturally and linguistically diverse groups including Māori
Population Health
- Understand frequency (NZ Youth health survey 2012 estimated that approximately 1.2% of adolescents identify as transgender)
- Associated health risks for marginalised group (mental health, sexual violence, discrimination and difficulty accessing health care)
- Understand frequency (NZ Youth health survey 2012 estimated that approximately 1.2% of adolescents identify as transgender)
- Associated health risks for marginalised group (mental health, sexual violence, discrimination and difficulty accessing health care)
Conditions to be considered relating to this scenario
Resources
https://www.kidshealth.org.nz/gender-diversity-children-young-people
https://researchcommons.waikato.ac.nz/handle/10289/12160 (Guidelines for gender affirming health care for gender diverse children , young people, and adults in Aotearoa New Zealand OLIPHANT j et al)
Australian standards of care and treatment guidelines for trans and gender diverse children and adolescents ( RCH Melbourne clinical guidelines)
