Question 2 - Ibrahim

Ibrahim is 19-yrs old and is a trans man from Saudi Arabia who came to the UK seeking asylum. He takes an SSRI for an episode of depression triggered by the lack of family acceptance forcing his decision to flee. He later confided in you that his brother would beat him, claiming that to support him would be haram (sinful).

Since you saw him last, he is doing very well, studying English and housed in a safe environment. He is ‘stealth’ (keeps his trans status private) with his fellow housemates and at college, afraid of further stigma, discrimination or violence.

He was self-injecting with Sustanon purchased via the internet for over a year but is now under the care of an NHS Gender Identity Clinic (GIC) for treatment and would like to switch to the long-acting preparation Nebido, but:

A

having virilised, he would no longer be a candidate for egg retrieval and storage

B

treatment with Nebido might make his mood more labile and interrupt his current run of good mental health

C

he will not require HPV vaccination

D

smoking may increase his risk of developing secondary polycythaemia

E

he should be referred for a transvaginal ultrasound scan to assess his endometrium after two years of testosterone therapy

 


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