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Case 4: Transgender Women and HIV

You answered:

A Doses of estrogens required for gender reassignment hormonal therapy are typically much lower than doses used for hormone replacement therapy in postmenopausal women.

This answer is incorrect. Estrogen doses used for gender reassignment therapy are generally significantly higher than those used for hormone replacement therapy in postmenopausal women.

Choose another answer:

B Considering this woman’s age, oral ethinyl estradiol (Estinyl) would be preferred over a transdermal estradiol patch. The oral estrogen treatment would have a significantly lower risk of causing thromboembolic complications than a transdermal estradiol patch.
C Anti-androgen therapy with spironolactone (Aldactone) is often used as part of hormonal gender reassignment therapy to further decrease male secondary sexual characteristics.
D No hormonal therapy should be given. The patient needs antiretroviral therapy and the co-administration of antiretroviral therapy and gender reassignment hormonal therapy is contraindicated.

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