Evaluation and Treatment of Gender Dysphoria to Prepare for Gender Confirmation Surgery

The document from October 1, 2018, provides a comprehensive review of the evaluation and treatment of gender dysphoria, particularly focusing on non-operative and operative treatments to prepare patients for gender confirmation surgery (GCS). It emphasizes the need for individualized, multidisciplinary care, including psychotherapy, social gender transition, and cross-sex hormone therapy, following the guidelines of the World Professional Association for Transgender Health (WPATH) and the Endocrine Society (ES). The document notes an increase in patients seeking treatment for gender dysphoria and a lack of experienced physicians. It outlines the benefits of hormone therapy, such as relief from dysphoria and improved quality of life, and discusses eligibility criteria for hormone therapy, including informed consent and management of comorbidities. The document also addresses the phenotypic effects of hormone therapy, such as changes in hair growth and distribution, and the safety profile of testosterone and estrogen therapy, including the risks of polycythemia and venous thromboembolism (VTE), respectively. It concludes that non-operative treatment is generally safe and effective, and that there is no increased risk of cancer associated with hormone therapy for transgender individuals. The document is part of a series, with subsequent parts focusing on the surgical aspects of gender dysphoria treatment.