Endocrine Treatment of Transsexual Persons:An Endocrine Society Clinical Practice Guideline

    Wylie C. Hembree, Peggy T. Cohen‐Kettenis, Henriëtte A. Delemarre-van de Waal, Louis Gooren, Walter J. Meyer, Norman P. Spack, Vin Tangpricha, Víctor M. Montori
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    TLDR The guideline recommends mental health involvement in diagnosing gender identity disorder and outlines hormone and surgical treatment protocols, emphasizing safety, informed consent, and long-term monitoring.
    The 2009 Endocrine Society Clinical Practice Guideline provided comprehensive recommendations for the endocrine treatment of transsexual persons. It stressed the role of mental health professionals in diagnosing gender identity disorder (GID) and guiding treatment, which includes psychotherapy, real-life experience (RLE), hormone therapy, and surgical therapy. For prepubertal children, hormone treatment was not recommended due to high rates of GID remission after puberty. Adolescents could begin puberty suppression with GnRH analogues at Tanner stage 2 and cross-sex hormones at age 16, while adults required confirmed GID diagnosis and evaluation of medical conditions before starting hormone therapy. The guideline advised maintaining hormone levels within the normal range for the desired gender and monitoring for adverse outcomes, such as cardiovascular risk and bone density. It also highlighted the importance of informed consent, fertility counseling before treatment, and considering surgery only after consistent hormone treatment and RLE. The document underscored the need for long-term studies to assess the safety and effects of these treatments.
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