Gonadal Suppressive and Cross-Sex Hormone Therapy for Gender Dysphoria in Adolescents and Adults

The document reviewed the therapeutic approaches for gender dysphoria in adolescents and adults, focusing on gonadal suppressive and cross-sex hormone therapy (CSHT). Adolescents with gender dysphoria received puberty suppression therapy, which improved behavior, emotional problems, depressive symptoms, and global functioning. Adults undergoing CSHT experienced improvements in gender dysphoria, psychological symptoms, quality of life, and sexual function. CSHT induced various physical changes within the first 6 months, with some effects taking 3-5 years to manifest fully. While bone mineral density was preserved with adequate hormone supplementation, long-term fracture risk remained unstudied. Transitioning to lower-dose regimens reduced the risk of venous thromboembolism and cardiovascular disease, though data quality was poor. Preliminary data suggested that CSHT did not increase breast cancer risk, but regular cancer screenings were recommended. The review highlighted the need for more long-term studies to optimize CSHT regimens for the transsexual population.