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为出生时被指定为女性的跨性别患者提供避孕咨询。

Contraceptive Counseling for the Transgender Patient Assigned Female at Birth.

机构信息

Universidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil.

Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2022 Sep;44(9):884-890. doi: 10.1055/s-0042-1751063. Epub 2022 Jul 6.

Abstract

Although almost 0.7% of the Brazilian population identifies as transgender, there is currently no training for healthcare professionals to provide comprehensive care to these patients, including the discussion of reproductive planning. The use of testosterone promotes amenorrhea in the first months of use; however, this effect does not guarantee contraceptive efficacy, and, consequently, increases the risks of unplanned pregnancy. The present article is an integrative review with the objective of evaluating and organizing the approach of contraceptive counseling for the transgender population who were assigned female at birth. We used the PubMed and Embase databases for our search, as well as international guidelines on care for the transgender population. Of 88 articles, 7 were used to develop the contraceptive counseling model. The model follows the following steps: 1. Addressing the information related to the need for contraception; 2. Evaluation of contraindications to the use of contraceptive methods (hormonal and nonhormonal); and 3. Side effects and possible discomfort associated with the use of contraception. The contraceptive counseling model is composed of 18 questions that address the indications and contraindications to the use of these methods, and a flowchart to assist patients in choosing a method that suits their needs.

摘要

尽管巴西有近 0.7%的人口认同自己为跨性别者,但目前还没有针对医疗保健专业人员的培训,以向这些患者提供全面的护理,包括生殖规划的讨论。使用睾丸素在使用的最初几个月会导致闭经;然而,这种效果并不能保证避孕的效果,因此增加了意外怀孕的风险。本文是一篇综合评价综述,旨在评估和组织针对出生时被指定为女性的跨性别者的避孕咨询方法。我们使用了 PubMed 和 Embase 数据库进行搜索,并参考了国际跨性别者护理指南。在 88 篇文章中,有 7 篇被用于开发避孕咨询模型。该模型遵循以下步骤:1. 提供与避孕需求相关的信息;2. 评估避孕方法使用的禁忌证(激素和非激素);3. 与避孕使用相关的副作用和可能的不适。避孕咨询模型由 18 个问题组成,涉及这些方法的适应证和禁忌证,并附有一个流程图,以帮助患者选择适合他们需求的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d3a/9948521/449be253f1c1/10-1055-s-0042-1751063-i210468-1.jpg

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