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Psychopharmacologic Considerations for Transgender and Gender Diverse People

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Transgender and gender diverse (TGD) people have a gender identity beyond societal expectations based on their sex assigned at birth.1 TGD communities encompass not only identities within a binary gender paradigm but also gender diversity that includes nonbinary, genderfluid, agender, and bigender identities.1 TGD people may choose to undergo gender-affirming medical care, such as hormone therapy or surgical intervention.1

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Jack L. Turban, MD, MHS, Division of Child & Adolescent Psychiatry, Stanford University School of Medicine, 401 Quarry Rd, Palo Alto, CA 94304 (jturban@stanford.edu).

Published Online: April 20, 2022. doi:10.1001/jamapsychiatry.2022.0662

Conflict of Interest Disclosures: Dr Turban reported receiving textbook royalties from Springer Nature; expert-witness payments from The American Civil Liberties Union and Lambda Legal; a pilot research award for general psychiatry residents from The American Academy of Child & Adolescent Psychiatry and its industry donors, Arbor and Pfizer; and a research fellowship from The Sorensen Foundation. Dr Keuroghlian reported receiving textbook royalties from McGraw Hill. No other disclosures were reported.

References
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Hembree  WC , Cohen-Kettenis  PT , Gooren  L ,  et al.  Endocrine treatment of gender-dysphoric/gender-incongruent persons: an endocrine society clinical practice guideline.   J Clin Endocrinol Metab. 2017;102(11):3869-3903. doi:10.1210/jc.2017-01658PubMedGoogle ScholarCrossref
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Franey  DG , Espiridion  ED .  Anabolic steroid-induced mania.   Cureus. 2018;10(8):e3163. doi:10.7759/cureus.3163PubMedGoogle Scholar
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Schatzberg  AF , Charles DeBattista  D .  Schatzberg’s Manual of Clinical Psychopharmacology. American Psychiatric Association Publishing; 2019.
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Bisson  JR , Chan  KJ , Safer  JD .  Prolactin levels do not rise among transgender women treated with estradiol and spironolactone.   Endocr Pract. 2018;24(7):646-651. doi:10.4158/EP-2018-0101PubMedGoogle ScholarCrossref
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Rauchenzauner  M , Deichmann  S , Pittschieler  S ,  et al.  Bidirectional interaction between oral contraception and lamotrigine in women with epilepsy—role of progestins.   Seizure. 2020;74:89-92. doi:10.1016/j.seizure.2019.11.011PubMedGoogle ScholarCrossref
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Richards  N , Reith  D , Stitely  M , Smith  A .  Are doses of lamotrigine or levetiracetam adjusted during pregnancy?   Epilepsia Open. 2017;3(1):86-90. doi:10.1002/epi4.12086PubMedGoogle ScholarCrossref
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