Welcome to the first Nugget of October 2018 - our month on Gender Identity, the Gender Spectrum, and Gender Transitions. We are really excited about this month so make sure you checked out our three earlier episodes this week - Monday, October 1's Monday Mumbling on the Gender Spectrum, Tuesdays Podcast with Dr. Raj Purohit of Mount Sinai on Gender Affirmation Surgery and Procedures and Monkeys Blog yesterday on his Gender Identity Experiences. In Today's Episode: We are really excited about Dr. Chubak's return to the barnyard. If you did not catch her earlier visit - you can go back and listen to her from our month on Professional Services where she spoke to us about good ways to find a doctor that will be your partner in your health journey. Today, Monkey got to sit down with Dr. Chubak again to talk about Gender. As a reminder, Barbara Chubak is a medical doctor at Mount Sinai and an assistant professor with the Department of Urology. She did many things before becoming a doctor, ranging from secretarial work to being a bioethicist, She is full of so much information and knowledge - we knew she would be a frequent visitor and long-term resident of the barnyard. In Dr. Chubak's work - she has an intake form where she asks new patients to her practice to fill out a questionnaire. Her first contact with patients, even before meeting them face to face, is to include the questions of preferred name and preferred pronoun as part of her standard intake. She finds this helpful to really relate to her patients. Of course, she does sometimes get pushback from her patients with these questions. She uses those pushbacks to initiate conversations as to the reasons why people are pushing back and why she feels it is important. Gender Identities and Terminologies: As always, we do like to find out the definitions people use for some of the common terms around each month's topics. Cisgender - having a gender identity that is consonant with one's biological sex. In other words, they match. Transgender -This definition is not universally true as trans-culture is growing and evolving and accepting more in the realm of gender fluidity and non-binary genders. Transgender started its foundations under the binary gender construct where there was a female gender and a male gender. The idea behind transgender was that someone would transition their gender so that their outsides matched their internal identification of gender, which is at the opposite end of the spectrum from the assigned sex at birth. Gender Transitions are the processes by which someone changes their physical appearance to match their gender identity through a series of physical changes. There are many different choices that can be made along that pathway and many extremes or minimums that can be chosen. Changes may be hormone therapy or surgical actions. There are additional socialization trainings and re-educations that can be undergone as well. Urology Concerns in Transgender Patients At every step of the way through the transitioning process, there are different needs from a medical standpoint. The one constant are the emotional needs of the people who are transitioning. It is critical to provide a supportive, reasonably non-judgemental environment so these individuals can feel comfortable and safe. The safety is critical because transgender people are going through extraordinary changes. Transgender Youth: Friends and family and a supportive network is really important. Moral and emotional support is really essential. This is even more important when it is children that are transgendered who are going through transition processes. The current medical guidelines around youth are pretty strongly in support of delaying puberty changes in order to simplify the transitioning process once the child is grown enough to provide their own...