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Evolving Neuropsychological Considerations and Case Studies of Individuals who Identify as Transgender and Gender Non-Binary/Nonconforming
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Credit
CE:1.5
Description
Individuals who identify as transgender (TG) and gender non-binary/nonconforming (NB/NC) face various medical, psychiatric, and social barriers. Specific to medical transition, there appears to be a rise in those seeking support related to gender-affirming medical and surgical interventions. However, the transition process requires a medical regimen that includes the use of hormone blockers and/or hormone replacement therapy (HRT), which can begin several years prior to surgery with ongoing sequelae well after transition has completed. While the World Professional Association for Transgender Health (WPATH) Standards of Care are the established guidelines for HRT within the TG and NB/NC population, they are not rigid, and HRT can be individualized based on anatomic, social, and/or psychological variables. Given the potential variability of when HRT is started, what type of HRT is implemented, and the duration of HRT over the lifespan, these variants in regimen can have significantly different impacts on psychiatric and neuropsychological health, including neurodevelopment, cognitive functioning, and neurodegeneration. In the context of understanding how transition may impact neuropsychological functioning, we will discuss the evolving best practice guidelines for selecting comparison data for cognitive and psychological measures as part of a neuropsychological assessment. We will conclude by discussing two clinical cases which differed in stage of life and transition (including TG vs. NB/NC). We will discuss how the results of neuropsychological testing impacted the transition process and how neuropsychologists can stay ahead of the curve in treating this population.
Presented by:
Michelle Cuevas, Ph.D. | Kaiser Permanente-Otay Mesa Clinic
Krista Freece, Ph.D., ABN | Kaiser Permanente- San Diego, CA
Jeffrey Ryan Murray, Psy.D. | Kaiser Permanente – Vallejo, CA
After the session, participants will be able to:
- Describe WPATH guidelines as they relate to the assessment and evaluation for Gender Dysphoria and readiness for medical transition.
- List at least three gender-specific neurological differences in individuals who identify as TG and NB/NC, as well as changes pre- and post-hormone treatment (e.g., HRT).
- Select appropriate comparison group data for cognitive and emotional measures based on the referral question, stage of medical transition, and unique characteristics of each examinee.
- Utilize information from this seminar to improve approaches to neuropsychological evaluation with individuals who identify as transgender or non-binary/nonconforming across various stages of transition.
INSTRUCTIONAL LEVEL: Intermediate