54% of trans women and 50% of trans men report having been harassed in the workplace. Transgender people who have been fired due to bias are more than 34 times likely than members of the general population to attempt suicide. Stealth
Many transsexual men and women choose to live completely as members of their gender without disclosing details of their birth-assigned sex. This approach is sometimes called stealth. Stealth transsexuals choose not to disclose their past for numerous reasons, including fear of discrimination and fear of physical violence. : 63  There are examples of people having been denied medical treatment upon discovery of their trans status, whether it was revealed by the patient or inadvertently discovered by the doctors. In the media
Before transsexual people were depicted in popular movies and television shows, Aleshia Brevard—a transsexual woman whose surgery took place in 1962: 3 —was actively working as an actress: 141  and model: 200  in Hollywood and New York throughout the 1960s and 70s. Aleshia never portrayed a transsexual person, though she appeared in eight Hollywood-produced films, on most of the popular variety shows of the day, including The Dean Martin Show, and was a regular on The Red Skelton Show and One Life to Live before returning to university to teach drama and acting. In pageantry
Since 2004, with the goal of crowning the top transsexual of the world, a beauty pageant by the name of The Worlds Most Beautiful Transsexual Contest was held in Las Vegas, Nevada.
There is a dose-dependent increase in the QT interval and the corrected QT interval (QTc). Because of this, many practitioners will initiate dofetilide therapy only on individuals under telemetry monitoring or if serial EKG measurements of QT and QTc can be performed. Pharmacokinetics
Peak plasma concentrations are seen two to three hours after oral dosing when fasting. Dofetilide is well absorbed in its oral form, with a bioavailability of >90%. Intravenous administration of dofetilide is not available in the United States. The elimination half-life of dofetilide is roughly 10 hours; however, this varies based on many physiologic factors (most significantly creatinine clearance), and ranges from 4.8 to 13.5 hours. Due to the significant level of renal elimination (80% unchanged, 20% metabolites), the dose of dofetilide must be adjusted to prevent toxicity due to impaired renal function.Dofetilide is metabolized predominantly by CYP3A4 enzymes predominantly in the liver and GI tract. This means that it is likely to interact with drugs that inhibit CYP3A4, such as erythromycin, clarithromycin, or ketoconazole, resulting in higher and potentially toxic levels of dofetilide. Metabolism
A steady-state plasma level of dofetilide is achieved in 2–3 days. 80% of dofetilide is excreted by the kidneys, so the dose of dofetilide should be adjusted in individuals with chronic kidney disease, based on creatinine clearance. In the kidneys, dofetilide is eliminated via cation exchange (secretion). Agents that interfere with the renal cation exchange system, such as verapamil, cimetidine, hydrochlorothiazide, itraconazole, ketoconazole, prochlorperazine, and trimethoprim should not be administered to individuals taking dofetilide.