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Hi, everybody. Thanks so much for joining. Once again, it's wonderful to see so many people turning up. If you could just give me a yes. If you can see me and hear me in the chat or a thumbs up, something like that. That would be brilliant. And if you can see my slides as well, just let me know if it is actually broadcasting out. Yep. Brilliant. Thank you so much. Ok. So I'm just gonna give it a couple of minutes to let a few more people join. Uh And then we'll get started. Oh, I will say in the meanwhile though, I will share the link for next week. Uh So usual time and place next Wednesday at 8 p.m. There's the link in the chat. We're looking at reproduction and fertility and the session is going to be run by uh Emily, a final year student. Uh So yeah, just join the link. Uh You can join the, the session by following the link and it'll take you through the normal registration questions. All right, I'll just give it a few more minutes then. Ok, let's um let's make a start. So I've introduced myself before. So I'm Alec, I'm one of the F ones working in Hull at the minute and I'm also the LGBT leave for mind the bleak. Um And I'll be given this session on transgender health. So first I'll just flag up the future sessions that we have. So, um next week, as I've already mentioned, uh we're looking at uh reproduction and fertility and then going on after that dermatology, Children and the elderly, et cetera, kind of culminating in this Q and A session at the end uh at the beginning of April where we've got a panel of um members of the community ready to answer your questions. Basically, any questions you might have um about their interactions with the health service and how we can change our practice to do better by them. So that would be a really valuable session, that one. But what are we gonna look at today? So this is briefly what we're going to cover. Uh We'll talk about the definition of multiple words to talk about trans and cis people, history of trans people. Um Coming down to how we can communicate better uh improve our consultations with trans people. And also talk briefly about the what transitioning actually involves because I think it's something that's widely misunderstood. Uh And then we've got some cases as well if we've got time at the end. All right. And um I will say it can be, I'd love for it to be interactive if you're happy to put things in the chat. So feel free to ask me questions as we go. I might ask some questions of you and you can put a reply in the chat and then that way we're all sort of learning more. OK, let's get going then. So first definition, uh obviously a key one. So what do we mean by transgender? So a transgender person is someone whose uh gender identity is different to their sex assigned at birth. So for example, someone might be born uh male and then they recognize in themselves that they're actually female and that would be a trans woman. And then obviously, it can happen the opposite way around uh compared to a cis gender person. So someone whose cis is someone whose gender identity is the same as the gender they were assigned at birth. So the prefixes Ciss in France uh did not just appear now. So they are really old prefixes and used in chemistry, I think originally uh to just mean something that is either on the same side of or on the opposite side of. So I ea this gender person who use this on the same side of because their gender is the same as what they are a sign of birth. Um So then we move down to a non binary person. So this is someone whose gender identity doesn't sit comfortably within male or female. So some people might view gender as a spectrum from uh male to female or, or masculinity to femininity. Uh Personally, I don't like that as a description, but that's for everyone to make their own mind up about. So, a non binary person may well view themselves as in between that spectrum. Um All they might view themselves is completely outside of it. And again, that's just for, for, for them to tell you how they feel um an intersex person then. So intersex people are included, have been included more in the LGBT community more recently. So these are people who are born with sexual characteristics that don't fit within the typical binary. So this could have been, is usually cos of a chromosomal difference. Um They might have ambiguous genitalia often in the past uh when intersex people were originally born, uh they would perform surgery on this newborn infant to kind of turn them into a boy or a girl uh because of the stigma surrounding it, which I think happens far less these days than for me. Um moving down then. So this terminology of assigned male or female at birth. So that can be shown to AAB or AFA. And by that, we're just referring to what we might term someone's natal sex. So the idea is the baby is born and the midwife will uh pick them up and look between their legs and say, oh, that's a boy. Oh, that's a girl. So that's their sex assigned at birth. And as we've just discussed with intersex people, it's really not that simple because it may be ambiguous. Uh It's not that simple because they may look uh phenotypically male, but end up having uh you know, xx chromosomes or the opposite way around. Um or they might end up being a trans person in which case, uh they might be assigned female at birth and then later identify as male, for example, And then M TF and FTM. So these are terms, some people might say they're outdated in my experience in the trans community, they are used frequently. Um So male to female would be describing a trans woman born a male and identifies as a female and female to male would be a trans man. And then what actually is gender dysphoria. So this is the state of distress and unhappiness that trans people experience because of this incongruence. Um And what I really want to point out is that it is different to body dysmorphia. So, uh body dysmorphia is like a uh uh recognizes a mental illness when you perceive parts of your body completely differently to how others perceive them and how they actually are. So, the recognized treatment for body dysmorphia is to deal with that mental health condition uh therapy. Basically, whereas the recognized treatment for gender dysphoria is to uh socially and or medically transition to the uh gender identity that that person feels OK. A couple of things I wanted to mention as well. Um where the people who are transvestites come into this. So typically the word transvestite um means someone who dresses in the opposite clothing to their sex. So kind of back in the day, I'd say this was far more relevant. I mean, these days, I think we're far more accepting.