Full Answer
What is hormone therapy for transgender women?
Hormone therapy for transgender women is intended to feminize patients by changing fat distribution, inducing breast formation, and reducing male pattern hair growth (11). Estrogens are the mainstay therapy for trans female patients.
What is the ISBN for endocrine therapy for transsexuals?
ISBN 978-0-89042-555-8. ^ Hembree, Wylie, C; Cohen-Kettenis, Peggy; Delemarre-van de Waal, Henriette; Gooren, Louis; Meyer III, Walter; Spack, Norman; Tangpricha, Vin; Montori, Victor (September 2009). "Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline".
Is hormone therapy in transgender adults safe with provider supervision?
"Hormone therapy in transgender adults is safe with provider supervision; A review of hormone therapy sequelae for transgender individuals." Journal of Clinical & Translational Endocrinology (2015)". Journal of Clinical & Translational Endocrinology. 2 (2): 55–60. doi: 10.1016/j.jcte.2015.02.003. PMC 5226129. PMID 28090436.
How should hormone therapy be tailored to a trans man's transition goals?
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.
How long is gender hormone therapy?
These include the dose and your body's response. For most people, it takes 18 to 24 months to achieve the full effect.
What is transgender hormone therapy called?
Transgender hormone therapy, also called hormone replacement therapy (HRT) or gender-affirming hormone therapy (GAHT), is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their ...
How long does hormone therapy take?
You may be offered hormone therapy for up to six months before radiotherapy. And you may continue to have hormone therapy during and after your radiotherapy, for up to three years. Some men might have hormone therapy on its own if radiotherapy or surgery aren't suitable for them.
How long does HRT work for transgender?
The maximum effect will occur within one to two years. Decreased spontaneous erections. This will begin one to three months after treatment. The maximum effect will occur within three to six months.
How long does it take to transition from female to male?
Some of the physical changes begin in as little as a month, though it may take as long as 5 years to see the maximum effect.
Do you have to take testosterone forever FTM?
Testosterone must be taken as directed by your endocrinologist or family doctor. While most trans men continue some level of testosterone hormone therapy for their entire lives, others will stop at some point.
Does estrogen stop facial hair growth MTF?
Body hair removal procedures While estrogen can help thin hair, it cannot completely reverse facial and body hair growth. Many trans women and other transgender people know all too well about how time-consuming daily grooming routines can be, so thankfully, there are alternative options available.
What age can you start hormone therapy?
If used in an adolescent, hormone therapy typically begins at age 16. Ideally, treatment starts before the development of secondary sex characteristics so that teens can go through puberty as their identified gender.
What is the success rate of hormone therapy?
Hormone replacement therapy users had a 100% survival rate at 6 years as opposed to 87% in nonusers. Both groups of tumors were detected by screening mammography, thus detected "early" by current convention. Yet, we observed a survival benefit for those women who had received HRT.
How do you start a transition MTF without hormones?
Here are common ways that people transition or live proudly as trans without hormones or surgery.Changing Your Name and Pronouns. ... Changing Your Hair. ... Updating Your Wardrobe. ... Changing What Bathroom/Facilities You Use. ... Legal Transition.
What happens when you stop taking testosterone FTM?
Stopping TRT will, in most cases, see your body revert to its previous state prior to commencing the treatment. Most patients report feeling more tired, weaker, losing muscle mass, increased fat, thinning hair, and lower sex drive.
How do you start a gender transition?
In general the first step is to explore your gender identity. This can include any combination of internal self-reflection, connecting with community and support groups, or working with a therapist who has expertise in gender identity issues. This process could take anywhere from months to years.
What is the term for the period of time a person spends in their desired gender role before starting hormone therapy?
This period is sometimes called real-life experience (RLE).
What is the treatment for transgender women?
This form of hormone therapy is given as one of two types, based on whether the goal of treatment is feminization or masculinization : Feminizing hormone therapy – for transgender women or transfeminine people; consists of estrogens and antiandrogens.
What is the purpose of feminizing hormone therapy?
Main article: Feminizing hormone therapy. Feminizing hormone therapy usually includes medication to suppress testosterone production and induce feminization. Types of medications include estrogens, antiandrogens (testosterone blockers), and progestogens. Most commonly, an estrogen is combined with an antiandrogen to suppress and block testosterone.
What is informed consent?
Many providers use informed consent, whereby someone seeking hormone therapy can sign a statement of informed consent and begin treatment without much gatekeeping. For other providers, eligibility is determined using major diagnostic tools such as ICD-10 or the Diagnostic and Statistical Manual of Mental Disorders (DSM).
What does it mean to be rid of your sexual characteristics?
A strong desire to be rid of one's sexual characteristics due to incongruence with one's experienced or expressed gender. A strong conviction that one has the typical reactions and feelings of a gender other than one's assigned gender.
What does it mean to be a gender?
A strong desire to be of a gender other than one's assigned gender. A strong desire to be treated as a gender other than one's assigned gender. A significant incongruence between one's experienced or expressed gender and one's sexual characteristics.
What is the criteria for transsexualism?
The criteria for transsexualism include: A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex. A wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex.
When does GNRH start?
What is the typical treatment time frame? For most children, puberty begins around ages 10 to 11, though some start earlier. The effect of pubertal blockers depends on when a child begins to take the medication. GnRH analogue treatment can begin at the start of puberty to delay secondary sex characteristics.
How often is GNRH given?
The medication is typically given as injections, either monthly or every three months, or through an implant placed under the skin of the upper arm. The implant typically needs to be replaced every 12 months.
What are the benefits of using pubertal blockers?
For children who have gender dys phoria, suppressing puberty might: Improve mental well-being.
What happens if a child stops taking GNRH?
If an adolescent child stops taking GnRH analogues, puberty will resume .
How to use pubertal blockers?
To begin using pubertal blockers, a child must: Show a long-lasting and intense pattern of gender nonconformity or gender dysphoria. Have gender dysphoria that began or worsened at the start of puberty. Address any psychological, medical or social problems that could interfere with treatment. Provide informed consent.
What is the name of the analogue of pubertal blocker?
Here's what you need to know about the pubertal blocker medication known as gonadotropin-releasing hormone (GnRH) analogues, including the benefits, side effects and long-term effects.
How to help children with gender dysphoria?
For children who have gender dysphoria, suppressing puberty might: Improve mental well-being. Reduce depression and anxiety. Improve social interactions and integration with other kids. Eliminate the need for future surgeries. Reduce thoughts or actions related to self-harm.
What is the standard of care for transgender children?
Shrier often conflates, causing confusion). The standard of care for children is that they get no medical intervention at all – no hormones, no surgery.
What are the criteria for adolescent puberty suppressing hormones?
In order for adolescents to receive puberty-suppressing hormones, the following minimum criteria must be met: The adolescent has demonstrated a long-lasting and intense pattern of gender nonconformity or gender dysphoria (whether suppressed or expressed); Gender dysphoria emerged or worsened with the onset of puberty;
Does gender affirming surgery improve psychological functioning?
Findings from this review indicate that GAS [gender-affirming surgery] can lead to multiple, significant improvements in psychological functioning. A 2020 study of hormonal therapy in trans teens found it decreased suicidal ideation and improved quality of life.
Is gender identity a disorder?
The DSM-V now recognizes that having a gender identity that differs from the gender assigned at birth is not a disorder. Having dysphoria resulting from that fact combined with social factors is. Further, DNA is demonstrably not determinative when it comes to sexual orientation and gender identity.
When should I stop testosterone?
It is reasonable to consider discontinuing hormone therapy at or around age 50, the age at which non-transgender women undergo menopause.
What is informed consent?
Informed consent is a process which occurs between a patient and a provider. The process should include an individualized discussion of the risks, benefits, unknowns, alternatives, and risk of no treatment. We are no longer recommending the use of consent forms for hormone therapy.
Is testosterone therapy contraindicated?
Testosterone therapy in patients with a prior history of cancer: An active sex hormone-sensitive cancer is an absolute contraindication to testosterone therapy. For patients with a prior history of hormone sensitive cancer (i.e. breast), consultation with an oncologist is recommended.
Is mid cycle testosterone good?
When measuring hormone levels in patients using injected forms of testosterone, a mid-cycle level is often sufficient however if the patient is experiencing cyclic symptoms such as migraines, pelvic cramping, or mood swings. Peak (1-2 days post injection) and trough levels of testosterone may reveal wide fluctuations in hormone levels over the dosing cycle; in these cases, consider changing to a transdermal preparation, or reducing the injection interval (with concomitant reduction in dose, to maintain the same total dose administered over time). [16,17]
Can transgender men lose hair?
Hair Loss: Hair loss may begin soon after beginning hormone therapy, and is dependent on genetic factors. There are two patterns of hair loss seen in transgender men; Frontal and temporal recession, and male-pattern baldness (receding at the forehead and thinning at the crown).
Is SHBG elevated in estrogen?
SHBG is elevated in the presence of estrogen and thyroxine. [10] . It is decreased in the presence of androgens, prolactin, and high levels of insulin and growth hormone. For transgender care, The Endocrine Society recommends monitoring of the total testosterone level. [11] .
Can the CoE respond to individual patient requests for medical guidance?
The CoE is unable to respond to individual patient requests for medical guidance. If you need medical advice, please contact your local primary care provider. If you need clarification, seek a second opinion locally or have your provider contact us for more information.
What is the Transgender Health Program?
Transgender Health Program: Hormone Therapy. If you are transitioning, hormone therapy may be your first medical step, regardless of whether you plan to have other gender-affirming treatments. At OHSU, providers will tailor your therapy to your goals. OHSU’s Transgender Gynecology clinic and many OHSU primary care clinics offer:
How does hormone therapy affect your body?
Hormone therapy effects. Physical: Your body will change over time . Your hair, skin, muscle mass and fat distribution will become different to varying degrees. Emotional: Hormone therapy can have some of the same effects on your emotions as puberty does. For example, you may swing from highs to lows often.
How long does it take for hormone therapy to start?
Timeline: You can often begin hormone therapy within a few weeks of your first visit with your provider. You will probably see some changes within months. Others can take years. You may decide to take hormone therapy for most of your life to maintain the effects.
What is hormone therapy?
Hormone therapy is medication to increase or suppress feminine or masculine hormones. It causes physical, emotional and other changes so you more closely match your gender identity. How much you take and for how long depend on your goals and other factors. Many people transition only through hormone therapy.
What is a testosterone blocker?
What are testosterone blockers? If you have testicles, your doctor may recommend a testosterone blocker, also called an antiandrogen , to enhance your estrogen therapy. Antiandrogens, usually taken as pills, block the effects of testosterone in your body. What to expect from testosterone blockers.
How long after first lab visit can you get results?
Most often, though, a second visit will allow time for results to come back and for your records to be reviewed. Your second visit. This usually happens a few weeks after your first visit.
Can hormones help with gender?
Hormones can also help your health after gender-affirming surgery, such as preventing bone loss if you’ve had your ovaries or testicles removed. Risks: Hormone therapy is likely to affect your sexual function and fertility, perhaps permanently. There may be long-term health risks.
What happens after HRT is stopped?
which are reversible after HRT is stopped, including. A decrease in acne. A decrease in facial and body hair. A decrease in muscle mass and strength Skin becomes softer and smoother Slowing of balding pattern. Redistribution of fat from the abdominal area to hips and buttocks.
What is the best doctor to consult for hormones?
Hormones are manufactured and controlled by the endocrine system, therefore, an endocrinologist is the best person to consult, if one is not available in your area then a good gynecologist would suffice, as they are often more understanding and are used to prescribing testosterone, estrogens, and progesterone.
How much does testicular size decrease?
Testicular size can be reduced by as much as 25 % in the first year. Female characteristic induction in the initial phases of hormone therapy can be quite painful and is common. The breast size evolves gradually with a period of little or no growth the maximum growth is attained over two years.
Is estrogen a superior estrogen?
In terms of its effect, there are no superior estrogens. The choice relies heavily on availability, cost and preference. Initial side effects are reported to be non-existent. All oral estrogens initially pass the liver after intestinal absorption and exert an effect on liver metabolism.
Is estrogen a good replacement for menopause?
These preparations are effective when given by mouth. Estrogen provides a satisfactory replacement hormone for treating menopausal symptoms and for reducing the risk of osteoporosis and cardiovascular disease in postmenopausal women.
Can progesterone be used for transsexuals?
The use of progesteron e to augment breast development is controversial in physicians treating MTF transsexuals. When deciding on a hormone regimen, it should be borne in mind that it is Estrogen that causes e serious side effects, so the lowest effective dose should be used.
Introduction
General Comments on Hormone Level Interpretation
Monitoring Testosterone Levels
Monitoring Hormone Levels in Patients Using Injected Testosterone
Monitoring Estradiol Levels
- A six-month prospective study of 31 transgender men newly started on testosterone found that only 9 (29%) achieved physiologic male-range estradiol levels. In reality, physiologic female estradiol ranges are wide and vary over the menstrual cycle; there can be significant overlap with the physiologic male range. Estradiol may play a role in pelvic ...
Interpreting Sex-Specific, Non-Hormone Labs
Individualized Dosing Based on Patient Centered Goals
Specific Considerations and Conditions
References