(In)Equality and Beyond: Achieving Justice in Gender-Affirming Hormone Initiation

Abstract

The World Professional Association for Transgender Health (WPATH) is an international organization that aims to advocate for transgender and gender-diverse (TGD) people by promoting safe and effective ways to access and deliver healthcare to maximize psychological health and well-being. One way this is achieved is through the WPATH's published Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, a set of guidelines for gender-affirming care that is based on the available science and expert consensus. In anticipation of the release of updated guidelines (Standards of Care Version 8) in 2022 the Radcliffe Institute for Advanced Study at Harvard University hosted an Exploratory Seminar in December 2021 that brought together experts from the United States, Mexico, and the United Kingdom to share knowledge across disciplines in order to propose revisions to the WPATH's updated guidelines. This article shares the workgroup's high-level consensus and recommendations.

The Role of Psychiatry for Transgender and Gender Diverse Adults

“…Beyond simply understanding clinical research that supports gender-affirming hormone therapy, psychiatrists should be familiar with the more granular pharmacologic considerations for such hormones emerging from certain published reviews and evolving clinical guidelines. 23 For example, case reports of mania induced by anabolic testosterone among cisgender men caused some concern that using testosterone to affirm gender identity might also have this side effect. Subsequent guidance, however, explains that maintaining serum testosterone levels comparable to those that occur endogenously among cisgender men, as opposed to the supraphysiologic levels that cisgender men pursue in misuse of anabolic testosterone, mitigates this risk.…”