What is the best treatment for transgender?
Hormone regimes for transgender men (female to men, FTM) 1. Oral Testosterone undecanoate* 160–240mg/day 2. Parenterally (i.m. or subcutaneous) Testosterone enanthate or cypionate 50–200mg/week or 100–200mg/2 weeks Testosterone undecanoate 1000 mg/12 weeks 3. Transdermal Testosterone 1% gel 2.5 – 10 g/day Testosterone patch 2.5 – 7.5 mg/day
How much does transgender medical treatment actually cost?
· Boosts the growth of facial and body hair Enlarges the clitoris Female hormones can make men appear more feminine. This treatment: Decreases muscle mass and strength Redistributes body fat...
How to cure transgender?
In proper doses, hormones are safe, but they should be prescribed and monitored by a physician to guard against dangerous side effects. Silicone Injections The use of unmonitored silicone injections is also a health concern for trans people who may be unable to access professional cosmetic surgery.
Why do transgender people need hormone therapy?
· Hormone therapy is another option for treating gender dysphoria, and it can be helpful either as a stand-alone therapy or in combination with other treatments. Hormone therapy is also recommended...
How do you treat transgender?
Medical treatmentHormone therapy, such as feminizing hormone therapy or masculinizing hormone therapy.Surgery, such as feminizing surgery or masculinizing surgery to change the chest, external genitalia, internal genitalia, facial features and body contour.
Is therapy required for transgender?
The World Professional Association for Transgender Health (WPATH) [2] does maintain that a mental health assessment “is needed” [3] for people wanting to modify their bodies for reasons of gender expression. That group also recommends—but does not require—psychotherapy as a prerequisite for body modifications [2].
What are the requirements for transgender?
a strong desire for the primary and/or secondary sex characteristics of the other gender. a strong desire to be of the other gender (or some alternative gender different from one's assigned gender) a strong desire to be treated as the other gender (or some alternative gender different from one's assigned gender)
What is the process for transgender?
For transgender and transsexual people, this process commonly involves reassignment therapy (which may include hormone replacement therapy and sex reassignment surgery), with their gender identity being opposite that of their birth-assigned sex and gender.
How do you start hormone therapy?
You'll begin masculinizing hormone therapy by taking testosterone. Typically, your doctor will prescribe a low dose and slowly increase the dosage over a period of months. Testosterone is given either by injection or a gel applied to the skin.
What is gender therapy?
Gender therapy focuses on the social, mental, emotional, and physical needs of those who: are questioning gender. are uncomfortable with aspects of their gender or body. are experiencing gender dysphoria. are seeking gender-affirming interventions.
How many genders are there?
two gendersThis idea that there are only two genders–and that each individual must be either one or the other–is called the “Gender binary.” However, throughout human history we know that many societies have seen, and continue to see, gender as a spectrum, and not limited to just two possibilities.
What are the guidelines for transgender athletes?
Transgender athletes will be required to document sport-specific testosterone levels four weeks before their sport's championship selections. For the 2022–23 academic year, the deadline will be at the beginning of their sport's season, with a second documentation six months after the first.
Can you take testosterone in NCAA?
On eligibility: Taking testosterone is legal in NCAA/IOC/FINA sports for treatment of gender dysphoria in trans men. T levels must be within an average male range, ergo, we have no testosterone 'advantage.
Is transgender surgery painful?
Some pain and discomfort is normal during recovery from gender reassignment surgery, but some patients have additional issues that impede the normal healing process and may cause pain to linger or even worsen over time.
Can a transgender get pregnant?
Pregnancy is possible for transgender men who retain functioning ovaries and a uterus, such as in the case of Thomas Beatie. Regardless of prior hormone replacement therapy treatments, the progression of pregnancy and birthing procedures are typically the same as those of cisgender women.
What age does transgender start?
The study results showed that the mean age of the transgender women's earliest general memory and first experience of gender dysphoria were 4.5 and 6.7 years, respectively. For transgender men they were 4.7 and 6.2 years, respectively.
Can transgender women have gender affirmation surgery?
Currently, most surgeons recommend that transgender women and transfeminine people stop taking estrogen before they undergo gender affirmation surgery. This is because of the potentially increased risk for blood clots that is caused both by estrogen and by being inactive after surgery.
What is transgender woman?
Lauren Schlanger, MD. Updated on June 14, 2021. Transgender women and transfeminine people are people whose assigned sex at birth is male, yet they exist as women. Transgender people represent a group that includes not just transgender women but also non-binary people who have a more feminine gender identity than the one ...
Can transgender women have breast augmentation?
As many as two-thirds of transgender women and transfeminine people are not satisfied with breast growth and may seek breast augmentation. Research suggests that this procedure depends on a number of factors including when hormone treatment is started and how fully testosterone is suppressed. 2 .
Can transgender women take oral estradiol?
Oral ethinyl estradiol is not recommended for use in transgender women because it is associated with an increased risk of blood clots. Conjugated estrogens are not used frequently, as they may put women at a higher risk of blood clots and heart attacks than 17B-estradiol, and they also cannot be accurately monitored with blood tests.
Can transfeminine people take testosterone blockers?
Testosterone blockers are a necessary part of estrogen treatment for transfeminine people because testosterone acts more strongly in the body than estrogen does. Therefore, in order for transfeminine people to experience the effects of estrogen treatment, they must block their testosterone. The most common medication used to block testosterone is ...
Is it safe to take estrogen injections?
In general, topical or injected estrogen treatment is thought to be safer than oral treatment. This is because there is no hepatic first pass effect. Topical and injectable estrogens also need to be taken less often, which may make dealing with them easier. However, there are downsides to these options as well.
Is estradiol used for heart attack?
1 . No matter what type of estrogen treatment is used, monitoring is important.
Why don't transgender people consult with doctors?
Barriers to Health Care. Some transgender people may not consult health care services because they have had negative experiences with doctors in the past. For that reason, organizations such as the World Professional Association for Transgender Health (WPATH) have created resources to help transgender people find knowledgeable, supportive, ...
What is the Center for Transgender Health?
Embracing diversity and inclusion, the Center for Transgender Health provides affirming, objective, person-centered care to improve health and enhance wellness; educates interdisciplinary health care professionals to provide culturally competent, evidence-based care; informs the public on transgender health issues; and advances medical knowledge by conducting biomedical research.
How to be empowered in healthcare?
For the best care possible, people should feel empowered to take an active role in their health by: 1 Voicing concerns if something doesn’t seem right. 2 Asking questions if they are unsure about any information. 3 Being forthcoming about any medications and past surgeries, as these may affect treatment plans and preventive care options.
What is the Wpath organization?
For that reason, organizations such as the World Professional Association for Transgender Health (WPATH) have created resources to help transgender people find knowledgeable, supportive, caring and compassionate providers in their communities. For the best care possible, people should feel empowered to take an active role in their health by:
What is transgender violence?
Transgender Violence. Transgender and gender-expansive people face a disproportionately high risk of physical and sexual violence in our society, much of which is motivated by hate or fear, and stems from a lack of understanding and acceptance.
What is intimate partner violence?
Intimate partner violence (sometimes called domestic violence) involves physical or emotional harm by a significant other — usually a partner, spouse or date. Typically, intimate partner violence begins with verbal threats and escalates to physical abuse, which is why it’s important to recognize it early and get help as soon as possible. Intimate partner violence often involves manipulation and control.
Why are transgender people fired?
Workplace Discrimination. Twenty-six percent of transgender and gender-expansive adults report being fired because of their identity. Because gender non-conforming people face such extreme job discrimination, some may turn to sex work as a last resort. This puts them at far greater risk of physical and sexual violence.
Is surgery necessary for gender dysphoria?
Treatments are based on your goals, as well as an evaluation of the risks and benefits of medication use, the presence of any other conditions, and consideration of your social and economic issues. Many people also find that surgery is necessary to relieve their gender dysphoria.
What is gender dysphoria?
Gender dysphoria involves feelings of distress due to a strong desire to be of another gender than the one assigned and by the extent and pervasiveness of gender-variant activities and interests.
What is behavioral therapy?
Behavioral health treatment. This treatment aims to improve your psychological well-being, quality of life and self-fulfillment. Behavioral therapy isn't intended to alter your gender identity. Instead, therapy can help you explore gender concerns and find ways to lessen gender dysphoria.
What is a pretreatment evaluation?
A pretreatment medical evaluation is done by a doctor with experience and expertise in transgender and intersex care before hormonal and surgical treatment of gender dysphoria. This can help rule out or address medical conditions that might affect these treatments or make the treatments inadvisable.
What are masculinizing surgeries, and how do they work?
The process of masculinizing often includes “top surgery” to remove breast tissue. ”I think a lot of trans men in general will just get top surgery and stop there,” depending on the level of dysphoria, says Dr. McClung. Others opt for “bottom surgery” to reconstruct the pelvic area.
What do feminizing surgeries involve?
Since hormone therapy itself can lead to breast tissue development, transgender women may or may not decide to have surgical breast augmentation.
Other surgeries that may be options
People who are agender or asexual may opt for nullification, meaning the removal of all sex organs. The external genitalia are removed, leaving an opening for urine to pass.
What doctors wish their patients knew before surgery
All in all, the entire transition process—living as your preferred gender, obtaining mental health referrals, getting insurance approvals, taking hormones, going through hair removal, and having various surgeries—can take years, doctors say.
What is the treatment for transgender men?
Many transgender men seek therapy for virilization and the mainstay treatment is exogenous testosterone. Transgender women desire suppression of androgenic effects and often use anti-androgen therapy with feminizing exogenous estrogens.
Do trans men need hormone therapy?
Many trans men seek maximum virilization, while others desire suppression of their natal secondary sex characteristics only. As a result, hormone therapy can be tailored to a patient’s transition goals, but must also take into account their medical comorbidities and the risks associated with hormone use.
What is a transgender man?
Transgender men are individuals who were assigned female at birth but identify as men, and transgender women are individuals who were assigned male at birth but identify as women. While research in this area is sparse, the current evidence points toward a biologic etiology for transgenderism.
What is testosterone therapy?
Testosterone. Testosterone therapy is used to suppress female secondary sex characteristics and masculinize transgender men. The therapy used resembles hormone replacement regimens used to treat natal men with hypogonadism and most of the preparations are testosterone esters.
Does testosterone help bone health?
Testosterone has a direct role in bone health maintenance, but the steroid is also aromatized peripherally to estradiol, which has a very important role as well (25). Testosterone also has an important role in increasing muscle mass, which further helps with bone health preservation.
Is there a large scale prospective study?
Large-scale prospective studies are lacking. Many of the studies that currently exist have small patient numbers as well as short or medium-term follow-up, and very few of the patients studied are over the age of 65. Furthermore, no head-to-head comparisons of hormone regimens have been published.
Is diabetes a risk factor for cardiovascular disease?
In addition, diabetes is a significant risk factor for cardiovascular disease and may have an important role in raising the risk of cardiovascular morbidity in trans women on estrogen, as this comorbidity has been found to be prevalent among the transgender population (32). Large-scale prospective studies are lacking.
Applying for Marketplace coverage
When you apply for Marketplace coverage as a transgender person, you should use the first, middle, and last name that are on your Social Security card.
Sex-specific preventive services
Marketplace health plans must cover a set of preventive services — like shots and screening tests — at no cost to you when delivered by a doctor or other provider within your plan’s network.
Plans with transgender exclusions
Many health plans are still using exclusions such as “services related to sex change” or “sex reassignment surgery” to deny coverage to transgender people for certain health care services. Coverage varies by state.
Can trans-masculine youth take testosterone?
Commonly, trans-masculine youth are either not yet ready for, or are not yet at an appropriate age to begin testosterone therapy, but are interested in induction of amenorrhea. GnRH analogues may be used in this situation, however access is often difficult for financial and other reasons, and these medications cannot be used without hormone replacement indefinitely. Other mechanisms for inducing amenorrhea include continuous administration of oral contraceptive pills, and progestogen-only long acting reversible contraceptives (LARC) such as depo-medroxyprogesterone acetate injections, a levonorgestrel intrauterine device (IUD), or etonogestrel rod implants (Grading: NT R M). Progesterone releasing intrauterine devices may result in amenorrhea in approximately half of all users. [15] Note that some trans-masculine youth are uncomfortable using "female" hormones, even for induction of amenorrhea. Youth can be informed that the administration of progestogens alone have little if any feminizing effect. Careful consideration of the individual's needs is critical in this decision making process.
What is gender affirming care?
Gender-affirming care for transgende r youth is a young and rapidly evolving field. In the absence of solid evidence, providers often must rely on the expert opinions of innovators and thought leaders in the field; many of these expert opinions are expressed in this youth guideline. The four primary authors for this youth protocol represent many years of expertise in clinical care and research, in both academic and community practice settings, and within the disciplines of adolescent medicine, pediatric endocrinology, family medicine, and advanced practice nursing.
When do children become aware of their gender?
Gender studies in non-transgender participants have found that children are aware of their gender by the age of five or six, and often earlier.
What is TGNC in medical?
Care for transgender and gender non-conforming ( TGNC) youth is a rapidly expanding field of medicine, and lends itself to controversy among professionals. It stands to reason that transgender adults started as transgender youth, and if identified in childhood or adolescence may benefit from early access to hormone blockers and/or gender-affirming ...
How often is leuprolide acetate given?
Leuprolide acetate can be delivered via injection anywhere from daily, to every 3 to 4 months. [12] Histrelin is delivered via a time-release implant that is surgically inserted in the underside of the upper arm. The implant lasts between 12 and 36 months.
Can you discontinue GnRH?
While extraordinarily rare, some youth may want to discontinue GnRH analogues and experience their endogenous puberty. For young people who remain gender dysphoric, and are interested in moving forward with masculinization or feminization, gender-affirming hormones can be added to GnRH analogues.
How is testosterone delivered?
Testosterone can be delivered by injection, or topically via gel, compounded cream or a patch. Most adolescents are not enthusiastic about using gels or patches for a variety of reasons including necessity of daily application, potential of absorption for others in close proximity, and high incidence of local skin irritation in when a patch is used. Although injectable testosterone has historically been given intramuscularly, many practices have moved toward the less painful, and equally effective subcutaneous delivery mechanism. [16] Some patients note a surge of hormone with subcutaneous dosing, as serum testosterone levels may rise rapidly. Subcutaneous dosing must be weekly as the testosterone level decreases significantly by a weeks' time, whereas intramuscular testosterone lasts longer and may be dosed either weekly or every other week.
Effects of Estrogen Treatment
Methods For Taking Estrogen
- Estrogen can be taken in a number of different ways. People receive estrogen through a pill, injection, patch, or even a topical cream. It's not just a matter of preference. The route by which people take estrogen affects some of the risks of estrogen treatment—estrogen is absorbed by the body differently depending on how you take it. Much of the research on the risks of estroge…
Types of Estrogens
- In addition to the different routes of administration of estrogen treatment, there are also different types of estrogens used for treatment. These include: 1. oral 17B-estradiol 2. oral conjugated estrogens 3. 17B-Estradiol patch (usually replaced every three to five days) 4. estradiol valerate injection (typically every two weeks) 5. estradiol cypionate injection (every one to two weeks) En…
Risks and Benefits
- By Route of Administration
In general, topical or injected estrogen treatment is thought to be safer than oral treatment. This is because there is no hepatic first pass effect. Topical and injectable estrogens also need to be taken less often, which may make dealing with them easier. However, there are downsides to th… - By Type of Estrogen
Oral ethinyl estradiol is not recommended for use in transgender women because it is associated with an increased risk of blood clots. Conjugated estrogens are not used frequently, as they may put women at a higher risk of blood clots and heart attacks than 17B-estradiol, and they also ca…
Treatment and Gender Surgery
- Currently, most surgeons recommend that transgender women and transfeminine people stop taking estrogen before they undergo gender affirmation surgery. This is because of the potentially increased risk for blood clots that is caused both by estrogen and by being inactive after surgery. However, it is unclear whether this recommendation is necessary...
Diagnosis
- Your health care provider might make a diagnosis of gender dysphoria based on: 1. Behavioral health evaluation.Your provider will evaluate you to confirm the presence of gender dysphoria and document how prejudice and discrimination due to your gender identity (minority stress factors) impact your mental health. Your provider will also ask about the degree of support you have fro…
Treatment
- Treatment can help people who have gender dysphoria explore their gender identity and find the gender role that feels comfortable for them, easing distress. However, treatment should be individualized. What might help one person might not help another. Treatment options might include changes in gender expression and role, hormone therapy, surgery, ...
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Coping and Support
- Gender dysphoria can be lessened by supportive environments and knowledge about treatment to reduce the difference between your inner gender identity and sex assigned at birth. Social support from family, friends and peers can be a protective factor against developing depression, suicidal thoughts, suicide attempts, anxiety or high-risk behaviors. Other options for support include: 1. …
Preparing For Your Appointment
- You may start by seeing your primary care provider. Or you may be referred to a behavioral health professional. Here's some information to help you get ready for your appointment.