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Link to original content: https://doi.org/10.1007/s40618-014-0186-2
Cross-sex hormone therapy for gender dysphoria | Journal of Endocrinological Investigation Skip to main content

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Cross-sex hormone therapy for gender dysphoria

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Abstract

Purpose

Gender identity is the sense one has of being male or female. Gender dysphoria (GD) refers to the distress caused by the incongruence between gender identity and biological sex in gender-nonconforming individuals. Cross-sex hormone therapy (CHT) aims at easing GD, improving well-being, and quality of life of gender-nonconforming individuals. This can be achieved by inducing and maintaining the desired-sex characteristics in accordance with the specific aspirations and expectations of each individual. Nevertheless, CHT can be associated with potentially serious long-term complications.

Methods

Here, we review when, how, and how long to prescribe CHT to adult transsexuals as well as what to expect and monitor once it has been initiated.

Results

In recent years, transsexualism has become more and more recognized and depathologized. To manage GD, National and International Standards of Care have been established. Nevertheless, the needs of transgender patients can still be ignored or dismissed. Moreover, some questions remain unanswered because of the lack of specific retrospective or prospective studies on CHT.

Conclusion

Education and culturally sensitive training must be supplied to healthcare professionals to overcome the existing issues on GD management and change the perspectives of transsexual people.

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Abbreviations

AIDS:

Acquired immunodeficiency syndrome

AT:

Antithrombin

BMI:

Body mass index

BRCA1:

Breast cancer 1

BRCA2:

Breast cancer 2

CVD:

Cardiovascular diseases

DRE:

Digital rectal examination

DSM-5:

Diagnostic and Statistical Manual of Mental Disorders 5th Edition

DVT:

Deep venous thrombosis

ECG:

Electrocardiogram

EE:

Ethinyl estradiol

FtM:

Female-to-male

GD:

Gender dysphoria

GnRHa:

Gonadotropin-releasing hormone agonists

HBsAb:

Hepatitis B surface antibody

HBsAg:

Hepatitis B surface antigen

HCV:

Hepatitis C virus

HIV:

Human immunodeficiency virus

HRT:

Hormone replacement therapy

ICD-10:

International Classification of Diseases 10

MtF:

Male-to-female

MTHFR:

Methylenetetrahydrofolate reductase

PAP:

Papanicolaou

PCOS:

Polycystic ovarian syndrome

PSA:

Prostate-specific antigen

SRS:

Sex reassignment surgery

TPHA:

Treponema pallidum hemo agglutination

US:

Ultrasound

VTE:

Venous thromboembolism

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Conflict of interest

All authors declare no conflict of interests, including any financial, personal or other relationships with other people or organizations.

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Authors and Affiliations

  1. Division of Internal Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy

    B. Fabris & S. Bernardi

  2. Division of Urology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy

    C. Trombetta

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  1. B. Fabris
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  2. S. Bernardi
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  3. C. Trombetta
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Correspondence to B. Fabris.

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Fabris, B., Bernardi, S. & Trombetta, C. Cross-sex hormone therapy for gender dysphoria. J Endocrinol Invest 38, 269–282 (2015). https://doi.org/10.1007/s40618-014-0186-2

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