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Management of transgenderism
1Endocrine Division, Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA. norman.spack@childrens.harvard.edu
JAMA
|February 7, 2013
Summary
Gender-affirming care, including hormone therapy and surgeries, is increasingly available for transgender individuals. Long-term effects of early puberty treatment remain unknown, necessitating careful medical monitoring and counseling.
Area of Science:
- Endocrinology and Medical Treatments
- Surgical Interventions in Gender Affirmation
Background:
- Gender identity disorder, or transgenderism, is not fully understood mechanistically or clinically.
- Societal acceptance and hormonal treatments contribute to increased awareness of gender identity conditions.
Observation:
- Therapeutic options for gender transition encompass hormone and surgical treatments.
- Treatment accessibility can be constrained by high costs and insurance coverage limitations.
Findings:
- Male-to-female (MTF) transition involves estrogens, finasteride, spironolactone, and GnRH analogs, alongside feminizing surgeries.
- Female-to-male (FTM) transition includes testosterone, GnRH analogs, mammoplasty, and phalloplasty.
- Medical therapies for both MTF and FTM transitions can commence in early puberty, with unknown long-term outcomes.
Implications:
- Comprehensive counseling and ongoing medical monitoring are essential for all patients undergoing gender-affirming treatments.
- Further research is needed to understand the long-term effects of early-onset gender-affirming medical interventions.
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