Treatment
8
Hormonal Therapy for Transgender Adults
➤ ES recommends that clinicians confirm the diagnostic criteria of GD/
GI and the criteria for the endocrine phase of gender transition before
beginning treatment. (1|⊕⊕⊕
)
➤ ES recommends that clinicians evaluate and address medical conditions
that can be exacerbated by hormone depletion and treatment with sex
hormones of the affirmed gender before beginning treatment. (1|⊕⊕⊕
)
➤ ES suggests that clinicians measure hormone levels during treatment to
ensure that endogenous sex steroids are suppressed and administered sex
steroids are maintained in the normal physiologic range for the affirmed
gender. (2|⊕⊕
)
➤ ES suggests that endocrinologists provide education to transgender
individuals undergoing treatment about the onset and time course of
physical changes induced by sex hormone treatment. (2|⊕
)
Table 4. Criteria for Gender-Affirming Hormone Therapy for
Adults
1. Persistent, well-documented gender dysphoria/gender incongruence
2. The capacity to make a fully informed decision and to consent for treatment
3. The age of majority in a given country (if younger, follow the criteria for adolescents)
4. Mental health concerns, if present, must be reasonably well controlled.
Reproduced from World Professional Association for Transgender Health. Available at: http://www.
wpath.org/site_page.cfm?pk_association_webpage_menu=1351&pk_association_webpage=3926.
Accessed 1 September 2017.
Table 5. Criteria for Gender-Affirming Hormone Therapy for
Adolescents
Adolescents are eligible for GnRH agonist treatment if:
1. A qualified MHP has confirmed that:
• The adolescent has demonstrated a long-lasting and intense pattern of gender
nonconformity or gender dysphoria (whether suppressed or expressed)
• Gender dysphoria worsened with the onset of puberty
• Any coexisting psychological, medical, or social problems that could interfere with
treatment (e.g., that may compromise treatment adherence) have been addressed,
such that the adolescent's situation and functioning are stable enough to start
treatment
• The adolescent has sufficient mental capacity to give informed consent to this
(reversible) treatment.
