Abstract：
Gender-affirming surgery includes a range of procedures that help align a transgender or gender diverse person\'s body with their gender identity. As rates of gender-affirming surgery increase, family physicians will need to have the knowledge and skills to provide lifelong health care to this population. Physicians should conduct an anatomic survey or organ inventory with patients to determine what health screenings are applicable. Health care maintenance should follow accepted guidelines for the body parts that are present. Patients do not require routine breast cancer screening after mastectomy; however, because there is residual breast tissue, symptoms of breast cancer warrant workup. After masculinizing genital surgery, patients should have lifelong follow-up with a urologist familiar with gender-affirming surgery. If a prostate examination is indicated after vaginoplasty, it should be performed vaginally. If a pelvic examination is indicated after vaginoplasty, it should be performed with a Pederson speculum or anoscope. After gonadectomy, patients require hormone therapy to prevent long-term morbidity associated with hypogonadism, including osteoporosis. The risk of sexually transmitted infections may change after genital surgery depending on the tissue used for the procedure. Patients should be offered the same testing and treatment for sexually transmitted infections as cisgender populations, with site-specific testing based on sexual history. If bowel tissue is used in vaginoplasty, vaginal bleeding may be caused by adenocarcinoma or inflammatory bowel disease. (Am Fam Physician. 2024;109(6):560-565.
摘要：
性别确认手术包括一系列程序，帮助跨性别或性别多样化的人的身体与他们的性别认同。随着性别确认手术率的增加，家庭医生需要具备为该人群提供终身医疗保健的知识和技能。医生应该对患者进行解剖调查或器官清查，以确定哪些健康检查是适用的。医疗保健维护应遵循现有身体部位的公认准则。患者在乳房切除术后不需要进行常规乳腺癌筛查；然而，因为有残留的乳房组织，乳腺癌的症状需要检查。生殖器男性化手术后，患者应与熟悉性别确认手术的泌尿科医师进行终身随访.如果阴道成形术后需要进行前列腺检查，应该通过阴道进行。如果阴道成形术后需要进行骨盆检查，它应该用Pederson窥器或肛门镜进行。性腺切除术后,患者需要激素治疗，以防止与性腺机能减退相关的长期发病率，包括骨质疏松症.根据手术所用的组织，生殖器手术后性传播感染的风险可能会发生变化。应该为患者提供与顺式人群相同的性传播感染检测和治疗，根据性史进行特定地点的测试。如果肠组织用于阴道成形术，阴道出血可能是由腺癌或炎症性肠病引起的。（我是法姆医生。2024；109（6）：560–565。
