Jamie Robinson, a 25-year-old transgender female, comes to your clinic

Jamie Robinson, a 25-year-old transgender female, comes to your clinic expressing a desire to start hormone replacement therapy to feminize her appearance. She has never undergone any form of HRT and has no significant medical history. Jamie mentions she wants to begin her physical transition and feels that now is the right time to start. She has been living as a female for the past year and seeks guidance on HRT. She is a non-smoker. She as of her visit today, she has a negative HIV status, but has sex with multiple biological male partners with unknown status. What are the first steps the NP would take during this consultation? (List at least 5 questions you would ask this patient during the initial consultation). What specific health screenings or assessments would the NP consider necessary before starting HRT? Jamie asks about the types of hormones involved, their effects, and potential side effects. How would you explain the effects and risks of estrogen therapy to Jamie? The NP decide that Jamie is a suitable candidate, from a medical perspective, for starting estrogen therapy. She needs guidance on the administration options and dosages. Which administration route would the NP discuss with Jamie? What are the key aspects to monitor in Jamie’s follow-up visits? At the end of her visit, Jamie complained that the office staff misgendered her and the office did not seem inclusive for her. List five ways to improve the clinical environment to be more inclusive and respectful.

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