Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline

Section: Introductionmentioning

confidence: 99%

Impact of cross‐sex hormone therapy on bone mineral density and body composition in transwomen

Fighera

Silva

Lindenau

et al. 2018

“…The established system is working in accordance with the standards 11 and current evidence-based clinical practice guideline, 12 leading to a high proportion of more than 90% of individuals that went to a trained mental health professional before the request for gender-reassignment treatment. In our cohort, we recorded a very small percentage of <2.5% with self-initiated GAHT compared with previous studies with up to more than 50%.…”

Section: Discussionmentioning

confidence: 99%

“…In 2017, the evidence-based clinical practice guideline of the Endocrine Society for endocrine treatment of individuals diagnosed with gender dysphoria was published. 12 According to this clinical practice guideline, our outpatient clinic, as most other centres in Germany, requires a written confirmation of gender dysphoria and an indication for treatment from a qualified mental health professional to initiate a gender-affirming hormone therapy (GAHT). The majority of German healthcare providers cover the costs of GAHT, if these requirements are met.…”

mentioning

confidence: 99%

Increasing normality–persisting barriers: Current socio‐demographic characteristics of 350 individuals diagnosed with gender dysphoria

Meyer

Mayer

Herrmann

et al. 2020

Introduction The number of individuals requesting medical treatment for gender dysphoria has increased significantly within the past years. Our purpose was to examine current biographic and socio‐demographic characteristics and aspects of legal gender reassignment. Design Medical files from n = 350 individuals of a German Endocrine outpatient clinic were collected from 2009 to 2017 and analysed retrospectively. Results Ratio of transwomen to transmen equates to 1:1.89 with a remarkable increase of transmen by the year 2013, showing a reversal of gender distribution compared with previous studies for the first time. Use of illegal substances or self‐initiated hormone therapy was rare (4.6 and 2.1%). Satisfaction with gender‐affirming hormone therapy was significantly higher in transmen than in transwomen (100% vs 96.2%, P = .005). Use of antidepressants declined significantly after onset of hormone treatment in transmen (13% vs 7%; P = .007). The number of individuals with a graduation diploma was only about half as high as in the general population (14.3% vs 27.3%), whereas unemployment rate was more than twice as high (14% vs 6.9%). Median latency between application for legal gender reassignment and definitive court decision was 9 months. Conclusions Our data provide possible indications for a decline of psychosocial burden in individuals diagnosed with gender dysphoria over the last years. However, affected individuals are still limited in their occupational and financial opportunities as well as by a complex and expensive procedure of legal gender reassignment in Germany.

“…Transgender (trans) including those who identify as gender diverse (TGD) is an umbrella terms for people whose gender identity or gender expression is different from what is typically associated with their sex assigned at birth. 1 There is increasing recognition that gender exists on a spectrum rather than a male/female binary. Gender-affirming hormone therapy (formerly referred to as cross-sex hormone therapy) is used to align a person's physical characteristics with their gender identity.…”

Section: Introductionmentioning

confidence: 99%

“…Endocrinologists have experience in prescribing hormone therapy and therefore often oversee this process. There are international transgender health guidelines to guide prescribing practitioners, 1,14 and the importance of gender-affirming hormone therapy is acknowledged by Endocrine societies worldwide. 11,12,15 Despite this, significant barriers exist in TGD health care.…”

Section: Introductionmentioning

confidence: 99%

Australian endocrinologists need more training in transgender health: A national survey

Bretherton

Grossmann

Leemaqz

et al. 2020

Objective An increasing number of trans and gender diverse (TGD) individuals are seeking gender‐affirming hormone therapy for gender transition. Little is known about the levels of training, experience and confidence of endocrinologists in providing care and lack of training and experience is a potential barrier to individuals seeking appropriate and timely health care. We aimed to assess the level of training and confidence of Australian endocrinologists and trainees in the endocrine management of trans and gender diverse individuals in a representative sample. Design Endocrinologist and trainee members of the Endocrine Society of Australia were invited to participate in an anonymous 14‐item survey. Of the 545 members, 147 clinicians (95 adult endocrinologists, 2 paediatric endocrinologists and 50 endocrinology trainees) responded. Results When presented with a scenario regarding commencement of gender‐affirming hormone therapy, only 19% felt confident providing clinical care to TGD individuals. Compared to other areas of endocrinology, 75% felt less or not at all confident in commencing hormone therapy in a TGD patient. No training in transgender medicine during medical school or during their endocrinology training was reported by 96% and 60%, respectively. There were significantly higher levels of confidence in all aspects including performing a consultation in those who had previously seen a TGD patient. The desire for more training was high (91%). Conclusions These results highlight the shortfall in training in TGD health care amongst endocrinologists and show that prior clinical experience is associated with higher levels of confidence. Medical schools and endocrinology fellowship training programmes will need to adapt to meet the increasing demand for quality TGD health services.