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Am Fam Physician. 2023;108(6):626-629

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• TGD people use terms to refer to themselves that can be personally and culturally important. Mirroring the patient’s language helps physicians provide more effective care.

• TGD people have higher rates of cardiovascular disease, partly due to undertreatment of risk factors.

• Gender-affirming treatment improves mental health and functioning and reduces suicidality. 

• Social transitioning is important for mental health and can occur before, concurrent with, or after medical transitioning depending on patient preference and age-specific treatment recommendations.

From the AFP Editors

Although less than 0.1% of people are identifiied as transgender and gender-diverse (TGD) in medical records, 0.5% of adults consider themselves transgender and up to 4.6% of adults assigned male at birth and 3.2% of adults assigned female at birth report gender incongruence or ambivalence. Up to 2.7% of children and adolescents consider themselves transgender. The World Professional Association for Transgender Health (WPATH) conducted systematic reviews to publish guidelines for care of TGD people.

TGD people often use names, pronouns, and terms for gender self-identity and body parts that vary based on personal preferences, cultural relevance, and shifting community standards. Mirroring this language and being aware of the stigma and discrimination they may experience can help physicians provide more affirmative and effective care.

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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, Assistant Medical Editor.

A collection of Practice Guidelines published in AFP is available at

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