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Gender Medicine Self-Assessment Questionnaire

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Gender Medicine Self-Assessment Questionnaire

The Gender Medicine Self-Assessment Questionnaire is designed to help individuals evaluate their experiences and needs related to their gender identity. By answering questions about gender identity, dysphoria intensity, social transition, support systems, mental health support, hormone replacement therapy, and gender-affirming surgeries, participants can gain insights into their personal journey and identify areas where additional support may be beneficial. This self-assessment aims to provide a clearer understanding of one’s gender-related experiences and the steps needed for a fulfilling transition.

Gender Medicine Self-Assessment Questionnaire

Gender Medicine Self-Assessment Questionnaire

1. What is your current gender identity?
2. What gender do you feel most comfortable identifying as?
3. How long have you been experiencing feelings of discomfort or dissatisfaction with your assigned gender at birth?
4. How would you rate the intensity of your gender dysphoria?
5. Have you started to socially transition to your desired gender (e.g., changing your name, pronouns, clothing)?
6. Do you have a support system (family, friends, community) that supports your gender identity and transition?
7. Are you currently seeing a mental health professional for support with your gender identity?
8. Are you interested in or currently undergoing hormone replacement therapy (HRT)?
9. Are you considering or have you undergone any gender-affirming surgeries (e.g., chest surgery, genital surgery)?
10. Do you have any existing medical conditions that might affect your transition?
11. Have you legally changed your name and gender marker on your identification documents?
12. Do you feel supported in your workplace or school environment regarding your gender identity?
13. Are you aware of community resources and support groups for transgender individuals?

Scoring Instructions:

 15-26 points:
o Gender Dysphoria Intensity: May need moderate support.
o Social Transition: Begin or continue social transition steps.
o Mental Health Support: Recommend consulting a mental health
professional.
o Medical Interventions: Explore options for HRT and surgeries.
o Legal Transition: Plan legal name and gender marker changes.
o Support Systems: Build a stronger support network.
o Community Resources: Engage with community resources.

 

27-39 points:
o Gender Dysphoria Intensity: High support required.
o Social Transition: Likely well underway; continue support.
o Mental Health Support: Essential to continue mental health support.
o Medical Interventions: Evaluate readiness for HRT and surgeries.
o Legal Transition: If not done, prioritize legal changes.
o Support Systems: Likely robust but may need strengthening.
o Community Resources: Actively utilize available resources.

 

Steps to Take
1. Consult a Mental Health Professional: Seek support from a mental health
professional experienced in gender issues to help navigate your feelings and plan your
transition.
2. Explore Medical Options: Schedule an appointment with a healthcare provider
specializing in gender medicine to discuss hormone replacement therapy (HRT) and
potential surgeries.
3. Build a Support System: Connect with supportive family members, friends, and
community groups to provide emotional and social support.
4. Legal Name and Gender Marker Change: Start the process of legally changing
your name and gender marker on identification documents.
5. Work and School Environment: Communicate with your workplace or school to
ensure a supportive and inclusive environment.
6. Utilize Community Resources: Engage with local and online transgender support
groups and organizations for additional resources and support.

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