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Maturitas. 2020 Feb;132:70-75. doi: 10.1016/j.maturitas.2019.12.005. Epub 2019 Dec 6.

Trans-specific Geriatric Health Assessment (TGHA): An inclusive clinical guideline for the geriatric transgender patient in a primary care setting.

Author information

1
Program for LGBTQ Health, Vanderbilt University Medical Center, Nashville, TN, USA; College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Kansas City, USA.
2
Program for LGBTQ Health, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
3
Program for LGBTQ Health, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
4
Program for LGBTQ Health, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA; Senior Associate Dean, Medical College of Wisconsin, USA. Electronic address: jehrenfeld@mcw.edu.

Abstract

There is a growing concern in the field of geriatric medicine that transgender health is often overlooked and under-reported. Not only does this impact the health and safety of the aging transgender community, but it also often influences the ability of physicians to provide high-quality evidence-based care. This article reviews the current knowledge base for geriatric transgender health and aims to organize evidence-based clinical recommendations for the primary care provider. Our proposed guideline, the Trans-specific Geriatric Health Assessment (TGHA), highlights areas of current clinical practice that do not address the geriatric transgender experience and modifies them to include trans-specific clinical recommendations found in the literature. The TGHA emphasizes topics such as cognitive function, vision and hearing, gait and stability, nutrition, sleep, functional/social status, urogenital health, psychiatric health, hormone replacement therapy, cancer screening, disease prevention and advanced care planning. Our review also addresses the limitations of certain clinical topics and where there is significant need for supportive research.

KEYWORDS:

Geriatric; Guidelines; Primary care; Transgender

PMID:
31883667
DOI:
10.1016/j.maturitas.2019.12.005
[Indexed for MEDLINE]

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