Course Description
Transgender men and women are people whose gender identity differs from their sex assigned at birth. Although the true prevalence of transgender people in the United States (US) and around the world is unknown due to biases in reporting, poor surveillance, and misapprehension of the myriad aspects of gender identification and expression, estimates suggest the total population ranges from 8 to 25 million globally, with about 12% to 15% living in the US. Transgender and nonbinary people are often subjected to discrimination and harassment from the public. Physical abuse is also common. Even within the healthcare system, transgender patients commonly face prejudice and exclusion. Medical care is often denied to transgender people because of their gender identity, healthcare providers are frequently ignorant of the issues and concerns pressing on this cohort, and healthcare facilities are often unwelcoming and insensitive. As a result, many transgender patients postpone essential medical care, delay diagnostic examinations, and often do not return for necessary follow-up care. These delays can be problematic, as transgender people have unique health-related needs due to their transitioning, which often involving gender-affirming hormone therapy, surgical reconstruction, and augmentation. During this process, breast imaging is an important component in the delivery of care. While diagnostic-imaging protocols for transgender patients are, in the main, similar to those for cisgender women, the screening guidelines promulgated by various professional societies differ. Emerging evidence suggests that transgender women taking hormone therapy may have an elevated risk of breast cancer. All members of the radiology care team must be aware of the breast-imaging considerations of this special population and the need to show compassion, respect, and inclusivity during all phases of the imaging examination. 

This course will explore the current place of mammography and breast imaging in caring for transgender patients. After delineating the recommended terminology to be used in addressing the transgender population, the need for heightened cultural sensitivity, and the importance of clear healthcare-provider and patient communication, factors related to medical hormone therapy, surgery, and breast development in transgender men and women will be discussed. Imaging characteristics and appearances will be described, as will a summary of the several professional society recommendations, focusing in particular on the American College of Radiology (ACR) Appropriateness Criteria for the use of mammography and other breast imaging. Special diagnostic considerations for transgender patients will also be discussed. An overview of current challenges, including barriers to care and the need to improve imaging-center performance will also be addressed. 

Learning Objectives
After completing this course, the participant should be able to:

• IDENTIFY the culturally sensitive terms and language for discussing transsexuality in a clinical setting.
• EVALUATE the effects of hormone therapy on the body and the risk of breast cancer.
• COMPARE the imaging features - the similarities and differences - between typical cisgender and transgender patients.
• OUTLINE the recommended criteria and guidelines for specific mammography and imaging procedures in transgender patients.
• APPRAISE the cultural and institutional barriers to care faced by transgender patients.

Categories: Mammography, Professional Development/Patient Care Quality, Ethics

In order to receive CE credit, you must first complete the activity content. When completed, go to the "Take CE Test!" link to access the post-test.

Submit the completed answers to determine if you have passed the post-test assessment. You must answer 18 out of 24 questions correctly to receive the CE credit. You will have no more than 3 attempts to successfully complete the post-test.

Participants successfully completing the activity content and passing the post-test will receive 2.5 ARRT Category A credits.

Approved by the American Society of Radiologic Technologists for ARRT Category A credit.

Approved by the state of Florida for ARRT Category A credit.

Texas indirect credit.

This activity may be available in multiple formats or from different sponsors. ARRT does not allow CE activities such as Internet courses, home study programs, or directed readings to be repeated for CE credit in the same biennium.

For ACCME Credit Provided by AKH Inc.

Release Date: August 3, 2022

Expiration Date: August 3, 2024

Target Audience
This activity is designed to meet the needs of Radiologic Technologists and Physicians, specifically Radiologists.

Method of Participation
In order to receive credit, participants should complete the pre-test, review the content, and continue to the post-test and evaluation. A certificate will generate upon successful submission of the post-test and evaluation. If you have questions about this CME activity, please contact AKH Inc. at wendi@akhcme.com.

CE credit provided by AKH Inc., Advancing Knowledge in Healthcare.  This activity is jointly-provided by AKH Inc., Advancing Knowledge in Healthcare and eRADIMAGING.

In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and eRADIMAGING. AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this enduring activity for a maximum of 2.5  AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosures

All of the relevant financial relationships listed for these individuals have been mitigated.

Commercial Support
There is no commercial support for this activity.

It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The planners and faculty must disclose to the participants any significant relationships with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients." or with the commercial supporter of this accredited continuing education activity. Identified conflicts of interest are mitigated by AKH prior to the planners/faculty assuming their role in this accredited continuing education activity.

Disclosure of Unlabeled Use and Investigational Products
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.