Transgender health.

Transgender persons represent an underserved community in need of sensitive, comprehensive health care. This article presents a literature-based review of the health needs of the transgender patient. Physicians, whether or not they choose to provide hormone therapy, will likely encounter patients with gender identity issues at some point in their practice. A transgender health assessment should involve recognition of possible gender identity disorder, history-taking with respect to prior and current use of hormones or surgical interventions, as well as general physical, mental, and sexual health histories. Physical exam and screening tests need to be based on the organ systems present rather than the perceived gender of the patient. Physicians should be aware of common hormone regimens and their associated risks. Finally, patients best explore transgender issues in a setting of respect and trust in which confidentiality concerns are addressed, and clinic staff are educated about transgender issues.