Medical Transition for Gender Diverse Patients
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CARE FOR THE TRANSGENDER PATIENTS (C FERRANDO, SECTION EDITOR)
Medical Transition for Gender Diverse Patients Chelsea N. Fortin 1 & Molly B. Moravek 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The purpose of this review is to provide an up-to-date overview of gender-affirming hormone therapy, including the various hormone regimens available, the efficacy and potential risks of these treatments, and considerations for surveillance and long-term care. Recent Findings Recent studies reaffirm that hormone therapy has positive physical and psychological effects for many transgender individuals. The overall risks of treatment are low. Transgender women may have an increased risk of venous thromboembolism and breast cancer based on recent cohort studies, but these findings have yet to be confirmed with randomized controlled trials. Important long-term considerations include metabolic, cardiovascular, and skeletal health. Summary High-quality, long-term studies on the effectiveness and safety of various gender-affirming hormone treatment regimens are lacking, but the currently available evidence suggests that it is overall safe and effective with appropriate oversight. Keywords Transgender . Hormone therapy . Gender-affirming treatment
Introduction Gender identity refers to one’s inner sense of being male, female, or an alternative gender [1]. Studies on the origin and determinants of gender identity negate the notion that gender identity is merely a psychosocial construct. Rather, there is increasing evidence that biological and environmental factors contribute to the development of one’s gender identity [2, 3]. Transgender individuals have a gender identity that is incongruent with their biological sex [1]. They often seek hormone therapy to harmonize their external appearance and affirmed gender, thereby alleviating feelings of gender dysphoria—distress experienced by those with gender incongruence [1]. As the number of transgender individuals seeking hormone therapy continues to grow [4], it is increasingly important for gynecologists to be informed of the basic tenets of transgender care. The objective of this review is to provide a summary of This article is part of the Topical Collection on Medical transition for gender diverse patients * Molly B. Moravek [email protected] 1
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Michigan, L4001 Women’s Hospital 1500 E Medical Center, Ann Arbor, MI, USA
current hormone regimens, the efficacy and potential risks of treatment, and considerations for surveillance and long-term care.
Initiation of Hormone Therapy Initiation of hormone therapy is often the first step towards reconciling the discordance between the transgender individual’s external appearance and true gender identity. The approach to hormone treatment must be individualized to ensure that the patient’s desired goals are achieved safely and effectively. A thorough history should be obtai
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