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Everything you wanted to know about hormones: Trans masculine

Introductory
Service Providers
Trans Communities
TOPIC AREAS
Core Concepts, Health, Self-Help, Sexual Harassment
PUBLICATION DATE
August 25, 2020

DESCRIPTION:
In part 2 of this 3-part series, Annie Lakatos, NP, will share her clinical experience in extensively working with trans men, trans-masculine, AFMAB individuals on their exploration and journey of using hormones (particularly testosterone) to feel more comfortable in their skin. This session will cover how to get started, what to expect, effects and risks, and health maintenance. Bring your questions. Everyone is welcome!

Clicking on timestamps will redirect you to the corresponding video section on YouTube.

Introduction 0:00
What we will cover
3:56
Guidelines for HRT
4:31
WPATH – Standards of Care
6:03
UCSF Transgender Guidelines
7:47
How to get started
10:20

Questions you may be asked at your first visit 14:07
Inner workings of an appointment
16:35
What to expect with HRT
19:17
Timeline of expected changes
22:18
Testosterone administration options
25:11

What Annie hears from her patients 26:44
Effects and risks of HRT
29:08
Risks associated with testosterone therapy
31:16
This is amazing! But what if…
34:52
Preventative health care
36:26

Q&A 39:28
How are hormones calibrated to individuals?
39:51
Is hormone recalibration associated with long-term effects?
40:59
Is a physical pelvic exam or HRT required for changing gender marker on ID?
42:39
Can you talk about pap alternatives?
43:31
What about testosterone pellets?
46:01

Are there any dietary/fitness methods to counteract risks? 46:59
Do you see much elevated bilirubin?
48:16
Does insurance coverage for cervical/breast cancer screenings change with using HRT?
48:53
Is there any interaction between testosterone and psychiatric medications?
50:05
Do caloric intake recommendations change from female to male while on HRT?
50:28
If the uterus and ovaries are retained, how is menopause affected?
51:49

Does initial bloodwork show existing testosterone levels? Does this influence dose? 53:42
Is it possible for a “middle ground” for T for a non-binary person?
55:14
Can you talk about Propecia for hair loss?
56:07
Should HRT dose change with age?
57:41
Is it more important to be physically active or be at a certain weight?
58:20
Can breasts be reduced instead of completely removed?
59:33

What can be done about polycythemia? 1:00:29
Testosterone and migraines, using gel instead, and insurance coverage?
1:02:26
Do I need to come into a clinic for injections?
1:03:52
Can pregnancy cause breast tissue to re-grow after top surgery?
1:04:49

PRESENTER: ANNIE LAKATOS, NP
Annie Lakatos has been a nurse practitioner since 2009 and works at Froedtert and the Medical College of Wisconsin in the Inclusion Health Clinic and the General Internal Medicine Clinic. She provides primary care, hormone replacement therapy and PrEP alongside preventive care and education. She is passionate about making each patient feel welcome and creating a space that is supportive and health-promoting for her patients.

Recorded on August 25, 2020.