Transgender Care: Recommended Guidelines, Practical Information, and Personal Accounts

301 Pages·1997·11.139 MB·English

by  Gianna E. Israel, Donald E. Tarver (eds.)

Transgender Care

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Transgender Care
Recommended Guidelines,
Practical Information,
and Personal Accounts
Written by and Essays Compiled by
Gianna E. Israel and
Donald E. Tarver II, M.D.
Foreword by Joy Diane Shaffer, M.D.
Temple University Press IiffiiI
Philadelphia Y
Temple University Press, Philadelphia 19122
Copyright © 1997 by Temple University
All rights reserved
Published 1997
Printed in the United States of America
Text design by Elizabeth Anne O'Donnell
§ The paper used in this publication meets the requirements of American National Stan
dard for Information Sciences-Permanence of Paper for Printed Library Materials,
ANSI Z39.48-1984
Library of Congress Cataloging-in-Publication Data
Israel, Gianna E., 1963-
Transgender care : recommended guidelines, practical information,
and personal accounts / written by and essays compiled by Gianna E.
Israel and Donald E. Tarver II ; foreword by Joy Diane Shaffer.
p. cm.
Includes index.
ISBN 1-56639-571-2 (alk. paper)
1. Transsexuals-Medical care. 2. Transsexuals-Mental health
services. I. Tarver, Donald E., 1960- II. Tide.
RA564.9.T73I87 1997
362.1' 086' 6-dc21 97-17280
To the health and well-being ofa ll transgender individuals
in pursuit ofs elf-determination and foil human rights

Contents
Foreword by Joy Diane Shaffer, MD. Xl Disclosure Concerns 48
Review Committee xv Basic Disclosure Tools 51
Disclosure to Children 53
Prefoce and Acknowledgments xvu
Recommended Guidelines
for the Residential Placement
Part I and Support of Transgender
Recommended Individuals in Social Service,
Mental Health, and Correctional
Guidelines
Settings 54
Chapter 1
Introduction 3 Chapter 3
Transgender Hormone
The Vocabulary and the Issues 6
Administration 56
Transgender Populations 14
Principles of Hormone
Administration 56
Chapter 2
Hormone Regimens: Biological Male
Mental Health 21
to Transgender Female
Mental Health Services 22 (MTF) 62
Psychiatric Diagnosis 24 Hormone Regimens: Biological
Crisis Intervention 32 Female to Transgender Male
Victimization 37 (FTM) 67
Key Mental Health Issues 39 Natural Hormones
Sexual Orientation 43 and Compounding
Sexual Orientation Profiles 46 Laboratories 68
vu
VllZ Contents
Clinical Laboratory Values 69 and Immunocompromised
Recommended Guidelines Individuals 122
for Hormone Administration 71
Chapter 7
Cultural Diversity 125
Chapter 4
Transgender Aesthetic Crosscultural Differences
Surgery 74 and the Provision of
Transgender Care 126
Principles of Transgender Aesthetic
Ethnicity, Race, and the Transgender
Surgery 74
Experience 128
Consumer Preparedness 75
Recommended Guidelines
Types of Procedures 77
for Transgender People
Recommended Guidelines
of Color 130
for Aesthetic Surgery 79
Chapter 8
Chapter 5 Transgender Youth 132
Genital Reassignment Surgery
The Transgender Experience
and Gonad Removal
in Adolescence 132
(Castration) 81
Family Responses 133
Principles of Genital Reassignment Society's Responses 134
Surgery 82 Helping Young People
Types of Procedures 85 with Gender Issues 136
Consumer Preparedness 86 Recommended Guidelines
Recommended Guidelines for Transgender Youth 140
for Genital Reassignment
Surgery 95 Chapter 9
Support Tools 142
Chapter 6 Advantage-Disadvantage Analysis 142
HIV and AIDS 99 First Contact Information 143
Basic Support Group Pointers 146
Transgender Support Services
Group Focus Survey 148
and AIDS 100
Postsurgical Follow-up Letters 149
Basic HIV and AIDS
Gender Identity Profile 151
Information 103
Courtesy Disclosure Letter 163
AIDS and the Transgender
Individual 104
Chapter 10
HIV Interviews 108
Support Scenarios 164
Recommended Guidelines
for Hormone Administration, Gender Differentiation and
Aesthetic Surgery, and Genital Placement in Residential
Reassignment in HIV-Positive Treatment Settings 165
Contents IX
Gender-Identity Issues and Alcohol Chapter 14
Dependency 167 You Are Not Alone:
When Resources Are Difficult A Personal Quest
to Locate 170 for a Support System 208
Employment Concerns
Ayme Michelle Kantz
for the Transgender
Individual 172
Fears about Victimization and Chapter 15
Coming Out 177 A Midlife Transition 211
Postsurgical Concerns 179
Heather Lamborn
Chapter 16
Part II Insurance and the Reimbursement
Essays of Transgender Health
Care 215
Lisa MiddLeton, MI!A.
Chapter 11
Standard Exclusionary
Ethical Implications for
Language 21 5
Psychotherapy with Individuals
Transgender Reimbursement Legal
Seeking Gender
Issues 216
Reassignment 185
Experimental Medicine
Barbara F Anderson, Ph.D., L.cs. W Reimbursement Legal
Issues 219
Medical Technology Assessment
Chapter 12 Practices 221
Understanding Your Rights
Individual Claim Strategies 222
under the San Francisco Conclusions 223
Ordinance 190
Larry Brinkin, Acting Coordinator, Chapter 17
San Francisco Human Rights Com minion Facial Surgery for the
Questions Commonly Asked Transsexual 225
about the Ordinances 190 DougLlls K Owter/lOut, D.D.S, M.D.
Remedies 193
Surgical Procedures 226
Findings and
Conclusion 228
Recommendations 194
Chapter 18
Chapter 13 What Is to Be Done?
From the Perspective of il Young A Commentary on the
Transsexual 203 Recommended Guidelines 229
Alexis Belindll /)illIlO Rachel Politick, M.A.