title: Primary care needs of patients who have undergone gender reassignment.
abstract: OBJECTIVE
  The purpose of this article is to inform nurse practitioners (NPs) about the primary care needs of patients who have undergone gender reassignment, either by hormone therapy alone or in conjunction with surgery.
  
  
  METHODS
  Data sources used were mainly from a review of the literature about gender identity disorder and gender reassignment. Information was also gathered from several leading surgeons on gender reassignment surgical procedures and subsequent clinical considerations.
  
  
  CONCLUSIONS
  There is very little written on the primary care clinical ramifications of transsexual patients and how clinicians can adapt their approaches to healthcare delivery to accommodate their special situations.
  
  
  CONCLUSIONS
  Implications for practice include how an NP can adapt clinical practice approaches to provide for patients who have undergone gender reassignment. Changes that occur in the transsexual process may warrant noncustomary primary healthcare screening and examination.
authors.affiliation: Shriners Hospitals for Children-Honolulu, Hawaii, USA. msobralske@shrinenet.org
authors.forename: Mary
authors.initials: M
authors.lastname: Sobralske
mesh_terms: D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008403:Mass Screening; D009722:Nurse Practitioners / Q000941:ethics / Q000458:organization & administration*; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D011361:Professional Competence / Q000592:standards; D012649:Self Concept; D014189:Transsexualism / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*