Introduction
Rising demand for gender‐affirming hormone therapy mandates a need for more formalised care of transgender and gender diverse (TGD) individuals in Australia. Estimates suggest that 0.1–2.0% of the population are TGD, yet medical education in transgender health is lacking. We aim to provide general practitioners, physicians and other medical professionals with specific Australian recommendations for the hormonal and related management of adult TGD individuals.
Main recommendations
Hormonal therapy is effective at aligning physical characteristics with gender identity and in addition to respectful care, may improve mental health symptoms.
Masculinising hormone therapy options include transdermal or intramuscular testosterone at standard doses.
Feminising hormone therapy options include transdermal or oral estradiol. Additional anti‐androgen therapy with cyproterone acetate or spironolactone is typically required.
Treatment should be adjusted to clinical response. For biochemical monitoring, target estradiol and testosterone levels in the reference range of the affirmed gender.
Monitoring is suggested for adverse effects of hormone therapy.
Preferred names in use and pronouns should be used during consultations and reflected in medical records.
While being TGD is not a mental health disorder, individualised mental health support to monitor mood during medical transition is recommended.
Changes in management as result of this position statement
Gender‐affirming hormone therapy is effective and, in the short term, relatively safe with appropriate monitoring. Further research is needed to guide clinical care and understand long term effects of hormonal therapies. We provide the first guidelines for medical practitioners to aid the provision of gender‐affirming care for Australian adult TGD individuals.
Although the majority of trans-and-gender-diverse patients attending the Gender Dysphoria Clinic were satisfied with the service they received, there is a need to identify strategies to facilitate timely access to the clinic.
Objective: This paper provides an update on recent developments at the largest state-funded gender clinic for adults in Australia. It focuses on the current staffing profile, the role of the mental health professional and the evolution of the clinic as a provider of specialist care supporting primary care providers who offer an informed consent model of care in accessing gender-affirming treatments. Conclusions: While significant improvements have been made at the clinic to provide comprehensive care in a framework that is viewed more favourably by clients, gaps in clinical service provision persist and are in need of urgent attention.
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