Endocrine intervention for transsexuals

The 2003 document reviews the condition of transsexualism and the use of hormone treatment for individuals seeking to transition. It outlines the consistent prevalence of transsexualism across cultures and the importance of a comprehensive clinical assessment and a multidisciplinary approach to treatment. The document details hormone treatment regimens for male-to-female and female-to-male transsexuals, including the use of oestradiol valerate, antiandrogens like spironolactone or cyproterone acetate, and progestogenic drugs, as well as finasteride and minoxidil for hair loss. It highlights the risks associated with hormone therapy, such as increased suicide rates, mood changes, and thromboembolic events. A retrospective study of 303 male-to-female transsexuals indicated a death rate five times higher than the reference population, mainly due to thromboembolic events. Another study with 816 male-to-female and 293 female-to-male transsexuals found no overall increase in mortality from hormone treatment, but did note venous thromboembolism as a significant risk. The document also discusses the effects on bone density, breast development, pituitary function, fertility, and ovarian histology, suggesting that while risks exist, most morbidity is minor and reversible.