Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo
diagramas, ilustraciones
- Autores:
-
Sánchez González, Juan Carlos
- Tipo de recurso:
- Tesis
- Fecha de publicación:
- 2021
- Institución:
- Universidad Nacional de Colombia
- Repositorio:
- Universidad Nacional de Colombia
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unal.edu.co:unal/79495
- Palabra clave:
- 610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
Cirugía Plástica
Surgery, Plastic
Feminización
Feminization
Personas Transgénero
Transgender Persons
Transgenero
DIsforia de genero
feminizacion facial
Transgender dysphoria
facial feminization
- Rights
- openAccess
- License
- Atribución-SinDerivadas 4.0 Internacional
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dc.title.spa.fl_str_mv |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo |
dc.title.translated.eng.fl_str_mv |
Facial feminization in transgender patients: Literature review and proposal of a management algorithm |
title |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo |
spellingShingle |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo 610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología Cirugía Plástica Surgery, Plastic Feminización Feminization Personas Transgénero Transgender Persons Transgenero DIsforia de genero feminizacion facial Transgender dysphoria facial feminization |
title_short |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo |
title_full |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo |
title_fullStr |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo |
title_full_unstemmed |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo |
title_sort |
Feminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejo |
dc.creator.fl_str_mv |
Sánchez González, Juan Carlos |
dc.contributor.advisor.none.fl_str_mv |
Gómez Díaz, Oswaldo Javier |
dc.contributor.author.none.fl_str_mv |
Sánchez González, Juan Carlos |
dc.contributor.researchgroup.spa.fl_str_mv |
PLASTICUN |
dc.subject.ddc.spa.fl_str_mv |
610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología |
topic |
610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología Cirugía Plástica Surgery, Plastic Feminización Feminization Personas Transgénero Transgender Persons Transgenero DIsforia de genero feminizacion facial Transgender dysphoria facial feminization |
dc.subject.decs.none.fl_str_mv |
Cirugía Plástica Surgery, Plastic Feminización Feminization Personas Transgénero Transgender Persons |
dc.subject.proposal.spa.fl_str_mv |
Transgenero DIsforia de genero feminizacion facial |
dc.subject.proposal.eng.fl_str_mv |
Transgender dysphoria facial feminization |
description |
diagramas, ilustraciones |
publishDate |
2021 |
dc.date.accessioned.none.fl_str_mv |
2021-05-10T21:46:41Z |
dc.date.available.none.fl_str_mv |
2021-05-10T21:46:41Z |
dc.date.issued.none.fl_str_mv |
2021 |
dc.type.spa.fl_str_mv |
Trabajo de grado - Especialidad Médica |
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info:eu-repo/semantics/masterThesis |
dc.type.version.spa.fl_str_mv |
info:eu-repo/semantics/acceptedVersion |
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http://purl.org/coar/resource_type/c_46ec |
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http://purl.org/redcol/resource_type/TM |
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https://repositorio.unal.edu.co/handle/unal/79495 |
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Universidad Nacional de Colombia |
dc.identifier.reponame.spa.fl_str_mv |
Repositorio Institucional Universidad Nacional de Colombia |
dc.identifier.repourl.spa.fl_str_mv |
https://repositorio.unal.edu.co/ |
url |
https://repositorio.unal.edu.co/handle/unal/79495 https://repositorio.unal.edu.co/ |
identifier_str_mv |
Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia |
dc.language.iso.spa.fl_str_mv |
spa |
language |
spa |
dc.relation.references.spa.fl_str_mv |
MARKS, D. Dermatologic Surgical Care for Transgender individuals,Dermatol Surg 2019;45(3):446–457 ISUNG, J. Craniofacial Reconstructive Surgery Improves Appearance Congruence in Male-to-Female Transsexual Patients. Arch Sex Behav. 2017 Aug;46(6):1573-1576. SCHECHTLER, L. Gender Confirmation Surgery: An Update for the Primary Care Provider. Transgend Health. 2016 Jan ;1(1):32-40 DUBOV, A. Facial Feminization Surgery: The Ethics of Gatekeeping in Transgender Health. Am J Bioeth. 2018 Dec;18(12):3-9 DESCHAMPS-BRALY, JC. Facial Gender Confirmation Surgery: Facial Feminization Surgery and Facial Masculinization Surgery. Clin Plast Surg. 2018 Jul;45(3):323-331. MORRISON,S. Lower Jaw Recontouring in facial Gender-Affirming Surgery. Facial Plast Surg Clin N Am (2019). MORRISON, S. et al. Facial Feminization: Systematic Review of the Literature. Plast Reconstr Surg. 2016 Jun;137(6):1759-70 PLEMONS, E. Formations of Femininity: Science and Aesthetics in Facial Feminization Surgery. Med Anthropol. 2017 Oct;36(7):629-641 WEISSLER, JM, et al. Gender-Affirming Surgery in Persons with Gender Dysphoria. Plast Reconstr Surg. 2018 Mar;141(3):388e-396e DESCHAMPS-BRALY JC. Approach to Feminization Surgery and Facial Masculinization Surgery: Aesthetic Goals and Principles of Management. J Craniofac Surg. 2019 Apr 2;00:00 1-7 HABAL, M. Aesthetics of feminizing the male face by craniofacial contouring of the facial bones. Aesth. Plast. Surg. 1990.(14):143-150 FONSECA, A. Disforia de género, presentación de un caso masculino a femenino (MTF) en el Hospital de San José. Repert Med Cir. 2016; 25 (4): 247-51 SELVAGGI, G. BELLRINGER, J. Gender reassignment surgery: an overview. Nat Rev Urol 2011 May;8(5):274-82 BERLI, J. et al.Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care, International Journal of Transgenderism.2017 18(3): 264-270 BECKING, A. Facial corrections in male to female transsexuals a preliminary report on 16 patients. J Oral Maxilofac Surg. 1996,(54):413-418 BERLI, J. et al. What Surgeons Need to Know About Gender Confirmation Surgery When Providing Care for Transgender Individuals: A Review. JAMA Surg. 2017 Apr 1;152(4):394-400 SPIEGEL, J.F. Challenges in Care of the Transgender Patient Seeking Facial Feminization Surgery. Facial Plast Surg Clin N Am. 2008.(16):233–238 RHODES, G et al Sex-typicality and attractiveness: are supermale and superfemale faces super-attractive?British Journal of psycholohgy. 2000. (91): 125-140 SOMENEK, M. Gender-Related Facial Surgical Goals. Facial Plast Surg. 2018 Oct;34(5):474-479 PROVOST, M. Sociosexuality in Women and Preference for Facial Masculinization and Somatotype in MenArchives of Sexual Behavior. 2006 (35): 305-312 BASHOUR, M. History and Current Concepts in the Analysis of Facial Attractiveness. Plast Reconstr Surg. 2006 Sep;118(3):741-56 SEDGH J. The Aesthetics of the Upper Face and Brow: Male and Female Differences. Facial Plast Surg. 2018 Apr;34(2):114-118 ASHA, M. et al. Nonsurgical Management of Facial Masculinization and Feminization. Aesthet Surg J. 2019 Apr 8;39(5):NP123-NP137 HAGE, J. Gender Confirming facial surgery considerations on the masculinity and femininity of faces. Plastic and Reconstructive Surgery Journal. 1997. 99;(7)1799-1807 SALGADO, C et al. Gender Reassignment: Feminization and Masculinization of the Neck. Clin Plast Surg. 2018 Oct;45(4):635-645 ALTMAN, K. Chapter 41, The Role of the Orthognathic Surgeon in Facial Feminization Surgery. Orthognathic Surgery: Principles, Planning and Practice, First Edition. 2016 VAN DE VEN, B. Facial feminisation, why and how? Sexologies (2008) (17): 291—298 BECKING, A.G. Trasgender feminization of the facial skeleton. Clinics in Plastic Surgery. 2007. (34) 557 -564 CAPITAN, L. et al. Facial Feminization Surgery: Simultaneous Hair Transplant during Forehead Reconstruction. Plast Reconstr Surg. 2017 Mar;139(3):573-584 OUSTERHOUT D. Feminization of the transexual, 1994. Recuperado de: https://www.transgendermap.com ALTMAN, K. Facial feminization surgery: current state of the art.Int. J. Oral Maxillofac. Surg. 2012 (41): 885–894 ALTMAN, K. Forehead reduction and orbital contouring in facial feminisation surgery for transgender females. Br J Oral Maxillofac Surg. 2018 Apr;56(3):192-197 HOEING, J. Frontal Bone Remodeling for Gender Reassignment of the Male Forehead: A Gender-Reassignment Surgery Aesth Plast Surg 201135):1043–1049 GUYRON, B. LEE, M. A Reappraisal of Surgical Techniques and Efficacy in Forehead Rejuvenation. PRS. 2014. 134(3):426-435 MARCELO, D. Forehead and Orbital Rim Remodeling.Facial Plast Surg Clin N Am. 2019. (16):1064-74 BERLI, J. LOYO, M. Gender-confirming Rhinoplasty. Facial Plast Surg Clin N Am. 2019. (27)251–260 REZA, S.A. The Role of Nasal Feminization Rhinoplasty in Male-to-Female Gender Reassignment ARCH FACIAL PLAST SURG. 2007.(9)5 319-321 SPIEGEL JH. Rhinoplasty as a Significant Component of Facial Feminization and Beautification. JAMA Facial Plast Surg. 2017 May 1;19(3):181-182 LUNDGREN TK, FARNEBO F. Midface Osteotomies for Feminization of the Facial Skeleton. Plast Reconstr Surg Glob Open. 2017 Jan 24;5(1):e1210 WHITEHEAD, D. Cheek Augmentation Techniques. Facial Plast Surg Clin N Am.2019; 1064-1074 DESCHAMPS-BRALY, J. Feminization of the ChinGenioplasty Using Osteotomies Facial Plast Surg Clin N Am.2019.(27):243–250 YAMECHUK, M. Improving aesthetic outcomes after alloplastic chin augmentation. Plastic and Reconstructive Surgery Journal. 2003. 112(5) :1422-1432 STRUM, A. CHAIET, S. Chondrolaryngoplasty Thyroid Cartilage Reduction. Facial Plast Surg Clin N Am.2019. (27):267–272 MUHN, C. ET AL. The evolving role of hyaluronic acid fillers for facial volume restoration and contouring: a Canadian overview Clinical, Cosmetic and Investigational Dermatology (2012):5 147–158 MARKS, D. Dermatologic Surgical Care for Transgender individuals, Dermatolog Surg (2019) SPRINGER, N. Facial attractiveness, visual impact of symmetry increases significantly towards the midline. Annals of plastic surgery. 2007. 59(2):159-162 COLEBUNDERS B, et al. An Update on the Surgical treatment for Transgender Patients. Sex Med Rev. 2017 Jan;5(1):103-109 GHASEM, M., KALANTAR, M.CASE REPORT: Feminizing the Male Face. E-plasty. 2009. (9):8-14 HABAL, M. Aesthetics of feminizing the male face by craniofacial contouring of the facial bones. Aesth. Plast. Surg. 1990. (14):143-150 SAFA, B. Current concepts in Feminizing Gender Surgery, Plast Reconstr Surg. 2019 May;143(5):1081e-1091e CHO, S-W, JIN, H.Feminization of the Forehead in a Transgender: Frontal Sinus Reshaping Combined with Brow Lift and Hairline Lowering. Aesth Plast Surg. 2012(36):1207–1210 GUYRO, B. ET AL.Endoscopic Correction of Frontal Bossing. Plast Reconstr Surg. 2013. 131(3):388-393 BARED, A, EPSTEIN, J. Hair Transplantation Techniques for the Transgender Patient. Plast Surg Clin N Am. 2019.(27): 227–232 ROHRICH RJ, et alt. Autologous Fat Grafting to the Chin: A Useful Adjunct in Complete Aesthetic Facial Rejuvenation. Plast Reconstr Surg. 2018 Oct;142(4):921-925. MONHEIT, G.Hyaluronic acid fillers for the male patient. Dermatology Therapy. 2007. (20):394-406 TERINO, E. Allloplastic Facial Contouring: Surgery of the Fourth plane. Aesth. Plast. Surg. 1992. (16): 195-212 DEMPF, R. ECKERT, A. Contouring the forehead and rhinoplasty in the feminization of the face in male-to-female transsexuals. J Craniomaxillofac Surg. 2010 Sep;38(6):416-22. LEE, M. SAKAI, O. SPIEGEL, J.CT measurement of the frontal sinus e Gender differences and implications for frontal cranioplasty. J Craniomaxillofac Surg. 2010 (38):494-500. RAFFAINI M, MAGRI AS, AGOSTINI T. Full Facial Feminization Surgery: Patient Satisfaction Assessment Based on 180 Procedures Involving 33 Consecutive Patients. Plast Reconstr Surg. 2016 Feb;137(2):438-48. BOUCHER F, GLEIZAL A, MOJALLAL A, BACHELET JT. Facial feminization surgery - middle and inferior thirds]. Ann Chir Plast Esthet. 2017 Apr;62(2):122-130. FONSECA, A, et al. Disforia de género, presentación de un caso masculino a femenino (MTF) en el Hospital de San José. Repert Med Cir. 2016; 25 (4): 247-51. ARNOLD JD, NELSON AE, LOUBIER EM. Transgender Surgery-Not the Benchmark for Gender Marker Determination. JAMA Surg. 2017 Dec 1;152(12):1099-1100. VAN DE GRIFT TC, et al. Surgical Satisfaction, Quality of Life, and Their Association After Gender-Affirming Surgery: A Follow-up Study. J Sex Marital Ther. 2018 Feb 17;44(2):138-148. BERLI, J et al.Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care, International Journal of Transgenderism. 2017. 18(3):264-270 ISUNG J, MÖLLERMARK C, FARNEBO F, LUNDGREN K. Craniofacial Reconstructive Surgery Improves Appearance Congruence in Male-to-Female Transsexual Patients. Arch Sex Behav. 2017 Aug;46(6):1573-1576. SADICK NS. Volumetric Structural Rejuvenation for the Male Face. Dermatol Clin. 2018 Jan;36(1):43-48 Tollinche LE et al. The Perioperative Care of the Transgender Patient. Anesth Analg. 2018 Aug;127(2):359-366. SMITH. O. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals. J Sex Med. 2018 Apr;15(4):591-600. SALIBIAN, A.A., et al. Preoperative and Postoperative Considerations in Gender-Affirming Surgery. Curr Sex Health Rep (2018) 10: 186. SEDGH J. The Aesthetics of the Upper Face and Brow: Male and Female Differences. Facial Plast Surg. 2018 Apr;34(2):114-118. WEISSLER JM, et al. Gender-Affirming Surgery in Persons with Gender Dysphoria. Plast Reconstr Surg. 2018 Mar;141(3):388e-396e. SOMENEK M. Gender-Related Facial Surgical Goals. Facial Plast Surg. 2018 Oct;34(5):474-479. SELVAGGI, G et al. Gender Affirmation Surgery. BioMed Research International, vol. 2018 SALGADO CJ et al. Gender Reassignment: Feminization and Masculinization of the Neck. Clin Plast Surg. 2018 Oct;45(4):635-645. DUBOV A, FRAENKEL L. Facial Feminization Surgery: The Ethics of Gatekeeping in Transgender Health. Am J Bioeth. 2018 Dec;18(12):3-9. MARKS, D et al. Dermatologic Surgical Care for Transgender individuals, Dermatolog Surg (2019) 45(3):446-457 AINSWORTH, T. SPIEGEL, J. Quality of individuals with and without facial feminization surgery or gender reassignment surgery. Qual Life Res.2010(19):1019–1024 BLUME-PEYTAVI, U.An overview of unwanted female hair. British Journal of Dermatology. 2011 165 (3):19–23 SELVAGGI, G. BELLRINGER, J. Gender reassignment surgery: an overview. Nat Rev Urol 2011 May;8(5):274-82 CHO, S-W, JIN, H.Feminization of the Forehead in a Transgender: Frontal Sinus Reshaping Combined with Brow Lift and Hairline Lowering. Aesth Plast Surg.2012. (6):1207–1210 BOHULI,B. Facial Sculpturing by Fat Grafting. A Textbook of Advanced Oral and Maxillofacial Surgery. 2013, chapter 31, 813-828. KWON PARK, D et al. Forehead Augmentation with a Methyl Methacrylate Onlay Implant Using an Injection-Molding Technique. APS. 2013(40):597-602 ENDARMA, M ET AL. Applications of Fat Grafting in Facial Aesthetic Skeletal Surgery. Aesthetic Surgery Journal 2014; 34(3) 363–373 MENDOZA, M. Cirugia estetica mandibular. Revista de Actualización Clínica. 2014. (46):2559-2563. OLATE, S Y MARAES, M. Cirugia facial estética: contribución de la osteotomia anterior de mandibula. Int. J. Med. Surg. Sci.2014; 1(3):247-252. ASCHER, B et al. Efficacy, patient-reported outcomes and safety profile of ATX-101 (deoxycholic acid), an injectable drug for the reduction of unwanted submental fat: results from a phase III, randomized, placebo-controlled study. JEADV. 2014. 1-9 STRUM, A. CHAIET, S. Chondrolaryngoplasty Thyroid Cartilage Reduction. Facial Plast Surg Clin N Am.2019.(27)267–272 LAKHIANI, C. SOMENEK, M.Gender-related Facial Analysis. Facial Plast Surg Clin N Am (2019) 1064-7406 SALIBIAN, A, BLUEBOND-LANGNER, R. Lip Lift. Facial Plast Surg Clin N Am. 2019. 1064-7406 |
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Universidad Nacional de Colombia |
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Bogotá - Medicina - Especialidad en Cirugía Plástica |
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Facultad de Medicina |
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Bogotá |
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Universidad Nacional de Colombia - Sede Bogotá |
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Universidad Nacional de Colombia |
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Atribución-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Gómez Díaz, Oswaldo Javierbcef53998fceadc06c3cbe77da3a285dSánchez González, Juan Carlos7a9bd757904ff8a203806cd5607658d3PLASTICUN2021-05-10T21:46:41Z2021-05-10T21:46:41Z2021https://repositorio.unal.edu.co/handle/unal/79495Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/diagramas, ilustracionesLa feminización facial en pacientes con disforia de género mejora la calidad de vida y los síntomas de ansiedad y depresión, sin embargo son pocas las guías de manejo interdisciplinario y quirúrgico basada en objetivos de feminización facial. Materiales y método: Se revisaron 1398 artículos de los cuales se seleccionaron 89 bajo los criterios de inclusión de feminización facial en paciente transgenero, excluyendo los artículos de manejo psicológico y ético. Resultados: En la revisión se identificaron los requisitos preoperatorios, los objetivos de feminización facial en el paciente transgenero y se propuso un algoritmo de manejo basado en tercios faciales guiado por objetivos de feminización facial, así como las recomendaciones preoperatorias y postoperatorias. Conclusiones: El manejo estructurado y por algoritmo en la feminización facial del paciente transgenero es ideal y mejora los resultados obtenidos.Facial feminization in patients with gender dysphoria improves quality of life and symptoms of anxiety and depression; however, interdisciplinary and surgical management guidelines based on facial feminization objectives are scarce. Materials and method: 1398 articles were reviewed, 89 of which were selected using the inclusion criterion of facial feminization of transgender patients; papers on psychological and ethical management were excluded. Results: The review identified preoperative requirements (hormonotherapy, urological/gynecological assessment, among others), facial feminization goals in the transgender patient, and a facial management algorithm was proposed based on facial thirds guided by facial feminization goals; preoperative and postoperative recommendations were also given. Conclusions: A structured and algorithm-based management for facial feminization in the transgender patient is ideal and improves the outcomes, with fewer complications and a higher rate of patient satisfaction.Especialidades MédicasRevisión de la literaturaFeminización facial en pacientes transgénero1 recurso en línea (47 páginas)application/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en Cirugía PlásticaFacultad de MedicinaBogotáUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiologíaCirugía PlásticaSurgery, PlasticFeminizaciónFeminizationPersonas TransgéneroTransgender PersonsTransgeneroDIsforia de generofeminizacion facialTransgender dysphoriafacial feminizationFeminización facial en pacientes transgenero: Revisión de la literatura y propuesta de un algoritmo de manejoFacial feminization in transgender patients: Literature review and proposal of a management algorithmTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_46ecTexthttp://purl.org/redcol/resource_type/TMMARKS, D. Dermatologic Surgical Care for Transgender individuals,Dermatol Surg 2019;45(3):446–457ISUNG, J. Craniofacial Reconstructive Surgery Improves Appearance Congruence in Male-to-Female Transsexual Patients. Arch Sex Behav. 2017 Aug;46(6):1573-1576.SCHECHTLER, L. Gender Confirmation Surgery: An Update for the Primary Care Provider. Transgend Health. 2016 Jan ;1(1):32-40DUBOV, A. Facial Feminization Surgery: The Ethics of Gatekeeping in Transgender Health. Am J Bioeth. 2018 Dec;18(12):3-9DESCHAMPS-BRALY, JC. Facial Gender Confirmation Surgery: Facial Feminization Surgery and Facial Masculinization Surgery. Clin Plast Surg. 2018 Jul;45(3):323-331.MORRISON,S. Lower Jaw Recontouring in facial Gender-Affirming Surgery. Facial Plast Surg Clin N Am (2019).MORRISON, S. et al. Facial Feminization: Systematic Review of the Literature. Plast Reconstr Surg. 2016 Jun;137(6):1759-70PLEMONS, E. Formations of Femininity: Science and Aesthetics in Facial Feminization Surgery. Med Anthropol. 2017 Oct;36(7):629-641WEISSLER, JM, et al. Gender-Affirming Surgery in Persons with Gender Dysphoria. Plast Reconstr Surg. 2018 Mar;141(3):388e-396eDESCHAMPS-BRALY JC. Approach to Feminization Surgery and Facial Masculinization Surgery: Aesthetic Goals and Principles of Management. J Craniofac Surg. 2019 Apr 2;00:00 1-7HABAL, M. Aesthetics of feminizing the male face by craniofacial contouring of the facial bones. Aesth. Plast. Surg. 1990.(14):143-150FONSECA, A. Disforia de género, presentación de un caso masculino a femenino (MTF) en el Hospital de San José. Repert Med Cir. 2016; 25 (4): 247-51SELVAGGI, G. BELLRINGER, J. Gender reassignment surgery: an overview. Nat Rev Urol 2011 May;8(5):274-82BERLI, J. et al.Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care, International Journal of Transgenderism.2017 18(3): 264-270BECKING, A. 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