Category: Federal Forum Posters
Purpose: To describe cross-sex hormone (CSH) prescribing and monitoring practices within a Veterans Affairs Health Care System (VAHCS). These practices will then be compared to the "Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline" (2017). The goal of this study is to obtain information to be utilized in developing a transgender medication order set to be used within the VAHCS electronic medical record (EMR).
Methods: Patients within the VAHCS and associated Community-Based Outpatient Clinics (CBOCs) with a diagnosis of gender dysphoria will be identified using ICD-10 codes. The study will exclude Veterans not currently on CSH therapy at the time of data retrieval. The following data will be collected: age, location of provider prescribing CSH (CBOC or main facility), duration of time receiving CSH prescriptions through the VAHCS, dose of CSH, and dosage form of CSH. For transfeminine Veterans, the following information will be collected: history of thromboembolic event documented in diagnosis list within EMR, most recent estradiol and testosterone levels, serum creatinine and potassium if prescribed spironolactone. For transmasculine Veterans, will collect most recent hematocrit and testosterone level. Other measures to be collected will examine utilization of the VA National Transgender e-Consultative service. This will include the number of providers who have submitted a consult and the number of consults entered. Finally, a chart review of the cohort will be conducted to compare CSH prescribing and monitoring to the Endocrine Society guidelines.
Results: Not applicable
Conclusion: Not applicable
Josh Brockbank– PGY1 Pharmacy Practice (Mental Health) Resident, Minneapolis VA Medical Center, Bloomington, MN