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Link to original content: https://doi.org/10.1007/978-1-4614-7441-8_14
Sex Reassignment: Endocrinological Interventions in Adults with Gender Dysphoria | SpringerLink
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Sex Reassignment: Endocrinological Interventions in Adults with Gender Dysphoria

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Gender Dysphoria and Disorders of Sex Development

Part of the book series: Focus on Sexuality Research ((FOSR))

Abstract

Transgender people may wish to transition to the other sex, usually to the fullest extent possible. Part of that transition is enabled by the administration of cross-sex hormones and part by surgical adaptation. The treatment of male-to-female transgender people consists of blocking androgen action and allowing estrogens to feminize the body. For virilization of female-to-male transgender people, androgens usually suffice. In adulthood, certain features of the sex hormone-induced body shape cannot be undone (such as the larger size of bones in males, the hip configuration in females). After about 2–3 years, the maximally attainable effects of cross-sex hormones have been reached. With competent endocrinological advice, cross-sex hormone treatment is usually uneventful. The estrogen ethinyl estradiol is to be avoided in view of the risks of venous thrombosis and cardiovascular disease. Androgen administration does not lead to an increase in cardiovascular disease. Hormone-dependent cancers have been observed in transgender people but not to an alarming degree. The relative rarity of transsexualism and the scattering of endocrine treatment over many centers is an impediment to build a solid body of knowledge with regard to efficacy and safety of cross-sex hormone treatment.

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References

  • Asscheman, H., Giltay, E. J., Megens, J. A., de Ronde, W. P., van Trotsenburg, M. A., & Gooren, L. J. (2011). A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. European Journal of Endocrinology, 164(4), 635–642.

    Article  PubMed  Google Scholar 

  • Asscheman, H., Gooren, L. J., & Eklund, P. L. (1989). Mortality and morbidity in transsexual patients with cross-gender hormone treatment. Metabolism, 38(9), 869–873.

    Article  PubMed  Google Scholar 

  • Baglietto, L., Severi, G., English, D. R., Krishnan, K., Hopper, J. L., McLean, C., et al. (2010). Circulating steroid hormone levels and risk of breast cancer for postmenopausal women. Cancer Epidemiological Biomarkers Prevention, 19(2), 492–502.

    Article  Google Scholar 

  • Ballantyne, K. N., Kayser, M., & Grootegoed, J. A. (2011). Sex and gender issues in competitive sports: Investigation of a historical case leads to a new viewpoint. British Journal of Sports Medicine, 46(8), 614–617.

    Article  PubMed  Google Scholar 

  • Becerra Fernandez, A., De Luis Roman, D., & Piedrola Maroto, G. (1999). Morbilidad en pacientes transexuales con autotratamiento hormonal para cambiar de sexo. Medicine Clinic (Barcelona), 113, 481–483.

    Google Scholar 

  • Benjamin, H. (1966). The transsexual phenomenon. New York, NY: Julian Press.

    Google Scholar 

  • Bentvelsen, F. M., Brinkmann, A. O., van der Schoot, P., van der Linden, J. E., van der Kwast, T. H., Boersma, W. J., et al. (1995). Developmental pattern and regulation by androgens of androgen receptor expression in the urogenital tract of the rat. Molecular and Cellular Endocrinology, 113(2), 245–253.

    Article  PubMed  Google Scholar 

  • Bentz, E. K., Pils, D., Bilban, M., Kaufmann, U., Hefler, L. A., Reinthaller, A., et al. (2010). Gene expression signatures of breast tissue before and after cross-sex hormone therapy in female-to-male transsexuals. Fertility and Sterility, 94(7), 2688–2696.

    Article  PubMed  Google Scholar 

  • Bunck, M. C., Debono, M., Giltay, E. J., Verheijen, A. T., Diamant, M., & Gooren, L. J. (2009). Autonomous prolactin secretion in two male-to-female transgender patients using conventional oestrogen dosages. BMJ Case Reports. pii: bcr02.2009.1589.

    Google Scholar 

  • Burcombe, R. J., Makris, A., Pittam, M., & Finer, N. (2003). Breast cancer after bilateral subcutaneous mastectomy in a female-to-male trans-sexual. Breast, 12(4), 290–293.

    Article  PubMed  Google Scholar 

  • Cebula, H., Pham, T. Q., Boyer, P., & Froelich, S. (2010). Regression of meningiomas after discontinuation of cyproterone acetate in a transsexual patient. Acta Neurochirurgica, 152(11), 1955–1956.

    Article  PubMed  Google Scholar 

  • Choong, K., Lakshman, K. M., & Bhasin, S. (2008). The physiological and pharmacological basis for the ergogenic effects of androgens in elite sports. Asian Journal of Andrology, 10(3), 351–363.

    Article  PubMed  Google Scholar 

  • De Sutter, P. (2001). Gender reassignment and assisted reproduction: Present and future reproductive options for transsexual people. Human Reproduction, 16(4), 612–614.

    Article  PubMed  Google Scholar 

  • Deipolyi, A. R., Han, S. J., & Parsa, A. T. (2010). Development of a symptomatic intracranial meningioma in a male-to-female transsexual after initiation of hormone therapy. Journal of Clinical Neuroscience, 17(10), 1324–1326.

    Article  PubMed  Google Scholar 

  • Dhand, A., & Dhaliwal, G. (2010). Examining patient conceptions: A case of metastatic breast cancer in an African American male to female transgender patient. Journal of General Internal Medicine, 25(2), 158–161.

    Article  PubMed  Google Scholar 

  • Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L., Langstrom, N., & Landen, M. (2011). Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study in Sweden. PLoS One, 6(2), e16885.

    Article  PubMed  Google Scholar 

  • Dimitrakakis, C., & Bondy, C. (2009). Androgens and the breast. Breast Cancer Research, 11(5), 212.

    Article  PubMed  Google Scholar 

  • Dizon, D. S., Tejada-Berges, T., Koelliker, S., Steinhoff, M., & Granai, C. O. (2006). Ovarian cancer associated with testosterone supplementation in a female-to-male transsexual patient. Gynecologic and Obstetric Investigation, 62(4), 226–228.

    Article  PubMed  Google Scholar 

  • Dorff, T. B., Shazer, R. L., Nepomuceno, E. M., & Tucker, S. J. (2007). Successful treatment of metastatic androgen-independent prostate carcinoma in a transsexual patient. Clinical Genitourinary Cancer, 5(5), 344–346.

    Article  PubMed  Google Scholar 

  • Dougherty, S. M., Mazhawidza, W., Bohn, A. R., Robinson, K. A., Mattingly, K. A., Blankenship, K. A., et al. (2006). Gender difference in the activity but not expression of estrogen receptors alpha and beta in human lung adenocarcinoma cells. Endocrine-Related Cancer, 13(1), 113–134.

    Article  PubMed  Google Scholar 

  • Driak, D., & Samudovsky, M. (2004). Cervical cancer in a female-to-male trans-sexual. European Journal of Cancer, 40(11), 1795.

    Article  PubMed  Google Scholar 

  • Galazis, N., Olaleye, O., Haoula, Z., Layfield, R., & Atiomo, W. (2012). Proteomic biomarkers for ovarian cancer risk in women with polycystic ovary syndrome: A systematic review and biomarker database integration. Fertility and Sterility, 98(6), 1590–1601.

    Article  PubMed  Google Scholar 

  • Ganly, I., & Taylor, E. W. (1995). Breast cancer in a trans-sexual man receiving hormone replacement therapy. The British Journal of Surgery, 82(3), 341.

    Article  PubMed  Google Scholar 

  • Garcia-Malpartida, K., Martin-Gorgojo, A., Rocha, M., Gomez-Balaguer, M., & Hernandez-Mijares, A. (2010). Prolactinoma induced by estrogen and cyproterone acetate in a male-to-female transsexual. Fertility and Sterility, 94(3), 1097. e1013–e1095.

    Article  PubMed  Google Scholar 

  • Gazzeri, R., Galarza, M., & Gazzeri, G. (2007). Growth of a meningioma in a transsexual patient after estrogen-progestin therapy. The New England Journal of Medicine, 357(23), 2411–2412.

    Article  PubMed  Google Scholar 

  • Gooren, L. J. (2011). Clinical practice. Care of transsexual persons. The New England Journal of Medicine, 364(13), 1251–1257.

    Article  PubMed  Google Scholar 

  • Gooren, L. J., Assies, J., Asscheman, H., de Slegte, R., & van Kessel, H. (1988). Estrogen-induced prolactinoma in a man. The Journal of Clinical Endocrinology and Metabolism, 66(2), 444–446.

    Article  PubMed  Google Scholar 

  • Gooren, L. J., & Behre, H. M. (2008). Testosterone treatment of hypogonadal men participating in competitive sports. Andrologia, 40(3), 195–199.

    Article  PubMed  Google Scholar 

  • Gooren, L. J., & Bunck, M. C. (2004). Transsexuals and competitive sports. European Journal of Endocrinology, 151(4), 425–429.

    Article  PubMed  Google Scholar 

  • Gooren, L. J., & Giltay, E. J. (2008). Review of studies of androgen treatment of female-to-male transsexuals: Effects and risks of administration of androgens to females. The Journal of Sexual Medicine, 5(4), 765–776.

    Article  PubMed  Google Scholar 

  • Gooren, L. J., Giltay, E. J., & Bunck, M. C. (2008). Long-term treatment of transsexuals with cross-sex hormones: Extensive personal experience. The Journal of Clinical Endocrinology and Metabolism, 93(1), 19–25.

    Article  PubMed  Google Scholar 

  • Gooren, L. J., Sungkaew, T., & Giltay, E. J. (2012). Exploration of functional health, mental well-being and cross-sex hormone use in a sample of Thai male-to-female transgendered persons (kathoeys). Asian Journal of Andrology. doi:10.1038/aja.2012.139.

    Google Scholar 

  • Grabellus, F., Worm, K., Willruth, A., Schmitz, K. J., Otterbach, F., Baba, H. A., et al. (2005). ETV6-NTRK3 gene fusion in a secretory carcinoma of the breast of a male-to-female transsexual. Breast, 14(1), 71–74.

    Article  PubMed  Google Scholar 

  • Grady, D., & Barrett-Connor, E. (2007). Postmenopausal hormone therapy. BMJ, 334(7599), 860–861.

    Article  PubMed  Google Scholar 

  • Grynberg, M., Fanchin, R., Dubost, G., Colau, J. C., Bremont-Weil, C., Frydman, R., et al. (2010). Histology of genital tract and breast tissue after long-term testosterone administration in a female-to-male transsexual population. Reproductive Biomedicine Online, 20(4), 553–558.

    Article  PubMed  Google Scholar 

  • Hage, J. J., Dekker, J. J., Karim, R. B., Verheijen, R. H., & Bloemena, E. (2000). Ovarian cancer in female-to-male transsexuals: Report of two cases. Gynecologic Oncology, 76(3), 413–415.

    Article  PubMed  Google Scholar 

  • Hamburger, C. (1969). Endocrine treatment of male and female transsexualism (pp. 291–307). Baltimore, MD: Johns Hopkins Press.

    Google Scholar 

  • Handelsman, D. J., & Gooren, L. J. (2008). Hormones and sport: Physiology, pharmacology and forensic science. Asian Journal of Andrology, 10(3), 348–350.

    Article  PubMed  Google Scholar 

  • Handelsman, D. J., & Heather, A. (2008). Androgen abuse in sports. Asian Journal of Andrology, 10(3), 403–415.

    Article  PubMed  Google Scholar 

  • Haring, R., Volzke, H., Felix, S. B., Schipf, S., Dorr, M., Rosskopf, D., et al. (2009). Prediction of metabolic syndrome by low serum testosterone levels in men: Results from the study of health in Pomerania. Diabetes, 58(9), 2027–2031.

    Article  PubMed  Google Scholar 

  • Hembree, W. C., Cohen-Kettenis, P., Delemarre-van de Waal, H. A., Gooren, L. J., Meyer, W. J., III, Spack, N. P., et al. (2009). Endocrine treatment of transsexual persons: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 94(9), 3132–3154.

    Article  PubMed  Google Scholar 

  • Institute of Medicine (Ed.). (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.

    Google Scholar 

  • Ito, K. (2007). Hormone replacement therapy and cancers: The biological roles of estrogen and progestin in tumorigenesis are different between the endometrium and breast. The Tohoku Journal of Experimental Medicine, 212(1), 1–12.

    Article  PubMed  Google Scholar 

  • Khosla, S. (2010). Update on estrogens and the skeleton. The Journal of Clinical Endocrinology and Metabolism, 95(8), 3569–3577.

    Article  PubMed  Google Scholar 

  • Kovacs, K., Stefaneanu, L., Ezzat, S., & Smyth, H. S. (1994). Prolactin-producing pituitary adenoma in a male-to-female transsexual patient with protracted estrogen administration. A morphologic study. Archives of Pathology and Laboratory Medicine, 118(5), 562–565.

    PubMed  Google Scholar 

  • Marjoribanks, J., Farquhar, C., Roberts, H., & Lethaby, A. (2012). Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database of Systematic Reviews (Online), 7, CD004143.

    Google Scholar 

  • Mauras, N., Hayes, V., Welch, S., Rini, A., Helgeson, K., Dokler, M., et al. (1998). Testosterone deficiency in young men: Marked alterations in whole body protein kinetics, strength, and adiposity. The Journal of Clinical Endocrinology and Metabolism, 83(6), 1886–1892.

    Article  PubMed  Google Scholar 

  • Meyer, W. J., Walker, P. A., & Suplee, Z. R. (1981). A survey of transsexual hormonal treatment in twenty gender-treatment centers. Journal of Sex Research, 17(4), 344–349.

    Article  Google Scholar 

  • Migeon, C. J., Rivarola, M. A., & Forest, M. G. (1968). Studies of androgens in transsexual subjects. Effects of estrogen therapy. The Johns Hopkins Medical Journal, 123(3), 128–133.

    PubMed  Google Scholar 

  • Miksad, R. A., Bubley, G., Church, P., Sanda, M., Rofsky, N., Kaplan, I., et al. (2006). Prostate cancer in a transgender woman 41 years after initiation of feminization. JAMA: The Journal of the American Medical Association, 296(19), 2316–2317.

    Article  Google Scholar 

  • Molokwu, C. N., Appelbaum, J. S., & Miksad, R. A. (2008). Detection of prostate cancer following gender reassignment. BJU International, 101(2), 259. author reply 259–260.

    Article  PubMed  Google Scholar 

  • Money, J. (1971). Transexualism and the philosophy of healing. The Journal of the American Society of Psychosomatic Dentistry and Medicine, 18, 25–26.

    Google Scholar 

  • Mueller, A., Dittrich, R., Binder, H., Kuehnel, W., Maltaris, T., Hoffmann, I., et al. (2005). High dose estrogen treatment increases bone mineral density in male-to-female transsexuals receiving gonadotropin-releasing hormone agonist in the absence of testosterone. European Journal of Endocrinology, 153(1), 107–113.

    Article  PubMed  Google Scholar 

  • Mueller, A., & Gooren, L. (2008). Hormone-related tumors in transsexuals receiving treatment with cross-sex hormones. European Journal of Endocrinology, 159(3), 197–202.

    Article  PubMed  Google Scholar 

  • Ott, J., Kaufmann, U., Bentz, E. K., Huber, J. C., & Tempfer, C. B. (2010). Incidence of thrombophilia and venous thrombosis in transsexuals under cross-sex hormone therapy. Fertility and Sterility, 93(4), 1267–1272.

    Article  PubMed  Google Scholar 

  • Pache, T. D., & Fauser, B. C. (1993). Polycystic ovaries in female-to-male transsexuals. Clinical Endocrinology, 39(6), 702–703.

    PubMed  Google Scholar 

  • Pritchard, T. J., Pankowsky, D. A., Crowe, J. P., & Abdul-Karim, F. W. (1988). Breast cancer in a male-to-female transsexual. A case report. JAMA: The Journal of the American Medical Association, 259(15), 2278–2280.

    Article  Google Scholar 

  • Ruetsche, A. G., Kneubuehl, R., Birkhaeuser, M. H., & Lippuner, K. (2005). Cortical and trabecular bone mineral density in transsexuals after long-term cross-sex hormonal treatment: A cross-sectional study. Osteoporosis International, 16(7), 791–798.

    Article  PubMed  Google Scholar 

  • Schenck, T. L., Holzbach, T., Zantl, N., Schuhmacher, C., Vogel, M., Seidl, S., et al. (2010). Vaginal carcinoma in a female-to-male transsexual. The Journal of Sexual Medicine, 7(8), 2899–2902.

    Article  PubMed  Google Scholar 

  • Schoemaker, M. J., Swerdlow, A. J., Higgins, C. D., Wright, A. F., & Jacobs, P. A. (2008). Cancer incidence in women with Turner syndrome in Great Britain: A national cohort study. The Lancet Oncology, 9(3), 239–246.

    Article  PubMed  Google Scholar 

  • Serri, O., Noiseux, D., Robert, F., & Hardy, J. (1996). Lactotroph hyperplasia in an estrogen treated male-to-female transsexual patient. The Journal of Clinical Endocrinology and Metabolism, 81(9), 3177–3179.

    Article  PubMed  Google Scholar 

  • Shao, T., Grossbard, M. L., & Klein, P. (2011). Breast cancer in female-to-male transsexuals: Two cases with a review of physiology and management. Clinical Breast Cancer, 11(6), 417–419.

    Article  PubMed  Google Scholar 

  • Slagter, M. H., Gooren, L. J., Scorilas, A., Petraki, C. D., & Diamandis, E. P. (2006). Effects of long-term androgen administration on breast tissue of female-to-male transsexuals. The Journal of Histochemistry and Cytochemistry, 54(8), 905–910.

    Article  PubMed  Google Scholar 

  • Slattery, M. L., Sweeney, C., Murtaugh, M., Ma, K. N., Caan, B. J., Potter, J. D., et al. (2006). Associations between vitamin D, vitamin D receptor gene and the androgen receptor gene with colon and rectal cancer. International Journal of Cancer, 118(12), 3140–3146.

    Article  Google Scholar 

  • Storer, T. W., Magliano, L., Woodhouse, L., Lee, M. L., Dzekov, C., Dzekov, J., et al. (2003). Testosterone dose-dependently increases maximal voluntary strength and leg power, but does not affect fatigability or specific tension. The Journal of Clinical Endocrinology and Metabolism, 88(4), 1478–1485.

    Article  PubMed  Google Scholar 

  • Symmers, W. S. (1968). Carcinoma of breast in trans-sexual individuals after surgical and hormonal interference with the primary and secondary sex characteristics. British Medical Journal, 2(5597), 83–85.

    Article  PubMed  Google Scholar 

  • Thurston, A. V. (1994). Carcinoma of the prostate in a transsexual. British Journal of Urology, 73(2), 217.

    Article  PubMed  Google Scholar 

  • Toorians, A. W., Thomassen, M. C., Zweegman, S., Magdeleyns, E. J., Tans, G., Gooren, L. J., et al. (2003). Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people. The Journal of Clinical Endocrinology and Metabolism, 88(12), 5723–5729.

    Article  PubMed  Google Scholar 

  • T’Sjoen, G., Weyers, S., Taes, Y., Lapauw, B., Toye, K., Goemaere, S., et al. (2009). Prevalence of low bone mass in relation to estrogen treatment and body composition in male-to-female transsexual persons. Journal of Clinical Densitometry, 12(3), 306–313.

    Article  PubMed  Google Scholar 

  • Turner, A., Chen, T. C., Barber, T. W., Malabanan, A. O., Holick, M. F., & Tangpricha, V. (2004). Testosterone increases bone mineral density in female-to-male transsexuals: A case series of 15 subjects. Clinical Endocrinology, 61(5), 560–566.

    Article  PubMed  Google Scholar 

  • Utian, W. H. (2012). A decade post WHI, menopausal hormone therapy comes full circle—Need for independent commission. Climacteric, 15(4), 320–325.

    Article  PubMed  Google Scholar 

  • Van Caenegem, E., Wierckx, K., Taes, Y., Dedecker, D., Van de Peer, F., Toye, K., et al. (2012). Bone mass, bone geometry, and body composition in female-to-male transsexual persons after long-term cross-sex hormonal therapy. The Journal of Clinical Endocrinology and Metabolism, 97(7), 2503–2511.

    Article  PubMed  Google Scholar 

  • van Haarst, E. P., Newling, D. W., Gooren, L. J., Asscheman, H., & Prenger, D. M. (1998). Metastatic prostatic carcinoma in a male-to-female transsexual. British Journal of Urology, 81(5), 776.

    Article  PubMed  Google Scholar 

  • van Kesteren, P. J., Asscheman, H., Megens, J. A., & Gooren, L. J. (1997). Mortality and morbidity in transsexual subjects treated with cross-sex hormones. Clinical Endocrinology, 47(3), 337–342.

    Article  PubMed  Google Scholar 

  • van Kesteren, P., Lips, P., Deville, W., Popp-Snijders, C., Asscheman, H., Megens, J., et al. (1996). The effect of one-year cross-sex hormonal treatment on bone metabolism and serum insulin-like growth factor-1 in transsexuals. The Journal of Clinical Endocrinology and Metabolism, 81(6), 2227–2232.

    Article  PubMed  Google Scholar 

  • van Kesteren, P., Lips, P., Gooren, L. J., Asscheman, H., & Megens, J. (1998). Long-term follow-up of bone mineral density and bone metabolism in transsexuals treated with cross-sex hormones. Clinical Endocrinology, 48(3), 347–354.

    Article  PubMed  Google Scholar 

  • Watts, N. B., Adler, R. A., Bilezikian, J. P., Drake, M. T., Eastell, R., Orwoll, E. S., et al. (2012). Osteoporosis in men: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism, 97(6), 1802–1822.

    Article  PubMed  Google Scholar 

  • Wierckx, K., Mueller, S., Weyers, S., Van Caenegem, E., Roef, G., Heylens, G., et al. (2012). Long-term evaluation of cross-sex hormone treatment in transsexual persons. The Journal of Sexual Medicine, 9(10), 2641–2651. doi:10.1111/j.1743-6109.2012.02876.x.

    Article  PubMed  Google Scholar 

  • Wierckx, K., Stuyver, I., Weyers, S., Hamada, A., Agarwal, A., De Sutter, P., et al. (2012). Sperm freezing in transsexual women. Archives of Sexual Behavior, 41(5), 1069–1071.

    Article  PubMed  Google Scholar 

  • Wierckx, K., Van Caenegem, E., Pennings, G., Elaut, E., Dedecker, D., Van de Peer, F., et al. (2012). Reproductive wish in transsexual men. Human Reproduction, 27(2), 483–487.

    Article  PubMed  Google Scholar 

  • Wigertz, A., Lonn, S., Mathiesen, T., Ahlbom, A., Hall, P., & Feychting, M. (2006). Risk of brain tumors associated with exposure to exogenous female sex hormones. American Journal of Epidemiology, 164(7), 629–636.

    Article  PubMed  Google Scholar 

  • Yeap, B. B. (2009). Are declining testosterone levels a major risk factor for ill-health in aging men? International Journal of Impotence Research, 21(1), 24–36.

    Article  PubMed  Google Scholar 

  • Yeap, B. B., Chubb, S. A., Hyde, Z., Jamrozik, K., Hankey, G. J., Flicker, L., et al. (2009). Lower serum testosterone is independently associated with insulin resistance in non-diabetic older men: The health in men study. European Journal of Endocrinology, 161(4), 591–598.

    Article  PubMed  Google Scholar 

  • Zitzmann, M., Erren, M., Kamischke, A., Simoni, M., & Nieschlag, E. (2005). Endogenous progesterone and the exogenous progestin norethisterone enanthate are associated with a proinflammatory profile in healthy men. The Journal of Clinical Endocrinology and Metabolism, 90(12), 6603–6608.

    Article  PubMed  Google Scholar 

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Acknowledgements

Financial support was received from Stichting Reproductieve Geneeskunde, Amsterdam, the Netherlands.

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Authors and Affiliations

  1. Androconsult, 72/1, moo 1. T.Palan, A.DoiSaket, Chiang Mai, 50220, Thailand

    Louis Gooren M.D., Ph.D.

  2. VU University Medical Center, 7057, 1007 MB, Amsterdam, The Netherlands

    Louis Gooren M.D., Ph.D.

  3. HAJAP, Valeriusstaat 4, 1071 MH, Amsterdam, The Netherlands

    Henk Asscheman M.D., Ph.D.

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  1. Louis Gooren M.D., Ph.D.
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Correspondence to Louis Gooren M.D., Ph.D. .

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Editors and Affiliations

  1. Center of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, ...., Amsterdam, 1007 MB, Netherlands

    Baudewijntje P.C. Kreukels

  2. Center of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, Amsterdam, 1007 MB, Netherlands

    Thomas D. Steensma

  3. Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psych, VU University Medical Center, P.O. Box 7057, Amsterdam, 1007 MB, Netherlands

    Annelou L.C. de Vries

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Gooren, L., Asscheman, H. (2014). Sex Reassignment: Endocrinological Interventions in Adults with Gender Dysphoria. In: Kreukels, B., Steensma, T., de Vries, A. (eds) Gender Dysphoria and Disorders of Sex Development. Focus on Sexuality Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-7441-8_14

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