Department of Medical Education, Icahn School of Medicine, New York, NY.
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada;
Clin Chem. 2017 Aug;63(8):1342-1352. doi: 10.1373/clinchem.2016.258780. Epub 2017 Jul 5.
Transgender is an umbrella term used to describe individuals who identify with a gender incongruent to or variant from their sex recorded at birth. Affirming gender identity through a variety of social, medical, and surgical interventions is critical to the mental health of transgender individuals. In recent years, awareness surrounding transgender identities has increased, which has highlighted the health disparities that parallel this demographic. These disparities are reflected in the experience of transgender patients and their providers when seeking clinical laboratory services.
Little is known about the effect of gender-affirming hormone therapy and surgery on optimal laboratory test interpretation. Efforts to diminish health disparities encountered by transgender individuals and their providers can be accomplished by increasing social and clinical awareness regarding sex/gender incongruence and gaining insight into the physiological manifestations and laboratory interpretations of gender-affirming strategies. This review summarizes knowledge required to understand transgender healthcare including current clinical interventions for gender dysphoria. Particular attention is paid to the subsequent impact of these interventions on laboratory test utilization and interpretation. Common nomenclature and system barriers are also discussed.
Understanding gender incongruence, the clinical changes associated with gender transition, and systemic barriers that maintain a gender/sex binary are key to providing adequate healthcare to transgender community. Transgender appropriate reference interval studies are virtually absent within the medical literature and should be explored. The laboratory has an important role in improving the physiological understanding, electronic medical system recognition, and overall social awareness of the transgender community.
跨性别是一个总称，用于描述那些认同与出生时记录的性别不一致或不同的个体。通过各种社会、医学和手术干预来确认性别认同，对跨性别个体的心理健康至关重要。近年来，人们对跨性别身份的认识有所提高，这突显了与这一人口统计学相关的健康差距。这些差距反映在寻求临床实验室服务的跨性别患者及其提供者的经历中。
人们对性别肯定激素治疗和手术对最佳实验室测试解释的影响知之甚少。通过提高对性/性别不一致的社会和临床认识，并深入了解性别肯定策略的生理表现和实验室解释，努力减少跨性别个体及其提供者所遇到的健康差距是可以实现的。这篇综述总结了理解跨性别医疗保健所需的知识，包括目前用于治疗性别焦虑症的临床干预措施。特别关注这些干预措施对实验室测试利用和解释的后续影响。还讨论了常见的命名法和系统障碍。
了解性别不一致、与性别过渡相关的临床变化以及维持性别/性二元性的系统障碍，是为跨性别社区提供充分医疗保健的关键。在医学文献中，几乎没有关于跨性别适当参考区间研究的内容，应该对此进行探讨。实验室在提高对跨性别群体的生理理解、电子病历系统识别以及整体社会认识方面发挥着重要作用。
