How Do Prescribing Clinicians Obtain Consent to Initiate Gender-Affirming Hormones?

Area of Science:

• Endocrinology
• Medical Ethics
• Public Health

Background:

• Gender-affirming hormone therapy (GAHT) initiation involves diverse consent processes.
• Understanding these variations is key to improving patient access and care equity.

Purpose of the Study:

• To examine the variety of consent models utilized by clinicians for initiating gender-affirming hormone therapy (GAHT).

Main Methods:

• Online and in-person recruitment of clinicians providing gender-affirming care.
• Online survey administered to 175 clinicians from June 2019 to March 2020.

Main Results:

• 148 clinicians prescribed GAHT; 51.4% treated both adults and minors.
• For adults, 54.4% used written consent, 24.3% verbal, and 21.3% required an additional mental health assessment (MHA).
• For minors, 44.8% required written consent and 40.2% an MHA; only 12.6% used verbal consent alone.

Conclusions:

• Significant variation exists in GAHT consent models across clinicians and patient age groups.
• Inconsistent approaches result in non-standardized patient access to care.
• Further standardization of GAHT care models is needed to ensure equitable treatment.