Care for the Transgender and Gender-Diverse Patient Population: A Review for the Obstetrician/Gynecologist

Abstract

anatomic sex), but also may refer to chromosomal, gonadal sex. 2,3 Sex assigned at birth generally is "male" or "female" though we know that chromosomal, gonadal, and anatomic sex does not exist in a binary. Assigned female at birth (AFAB) and assigned male at birth (AMAB) are common abbreviations used to discuss gonadal sex with regard to gender, whether incongruent, ambivalent, or concordant. In the United States, TGD people may self-identify with other terms including but not limited to trans, transgender, transsexual, gender nonconforming, gender queer, nonbinary, or intersex; individuals may also identify as masculine or feminine, male or female. 1,2 Cisgender in contrast is a term used to describe a person whose gender identity aligns with their assigned sex at birth. Table 1 provides further terminology and definitions. 2 Current estimates suggest that 0.02% to 8.4% of the population in the United States are TGD individuals, including approximately 1.4 million adults in the United States who identify as transgender. 1,2 The significant variation in estimates is due to the discrepancy in self-reported gender identity in survey data (0.3%-4.5% TGD adults, 1.2%-8.4%As care for transgender and gender-diverse individuals is increasingly threatened nationally, it is important to recognize the role of the obstetrician-gynecologist in advocating for, improving care for, and knowledgeably treating this patient population.Transgender and gender-diverse (TGD) is the accepted nomenclature for people with gender identities or gender expressions that differ from the gender socially attributed to the sex assigned to them at birth. 1 Sex as assigned at birth generally refers to external genitalia noted as a newborn