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Title: Position statement on the hormonal management of adult transgender and gender diverse individuals
Austin Authors: Cheung, Ada S ;Zajac, Jeffrey D ;Wynne, Katie;Erasmus, Jaco;Murray, Sally
Affiliation: Medicine (University of Melbourne)
Diabetes and Endocrinology, Hunter New England Health, Newcastle, NSW, Australia
Gender Clinic, Monash Health, Melbourne, Victoria, Australia
Sexual Health Service, Royal Perth Hospital, Perth, WA, Australia
Issue Date: Aug-2019
Date: 2019-07-04
Publication information: Medical Journal of Australia 2019; 211(3): 127-133
Abstract: Rising demand for gender-affirming hormone therapy mandates a need for more formalised care of transgender and gender diverse (TGD) individuals in Australia. Estimates suggest that 0.1-2.0% of the population are TGD, yet medical education in transgender health is lacking. We aim to provide general practitioners, physicians and other medical professionals with specific Australian recommendations for the hormonal and related management of adult TGD individuals. Hormonal therapy is effective at aligning physical characteristics with gender identity and in addition to respectful care, may improve mental health symptoms. Masculinising hormone therapy options include transdermal or intramuscular testosterone at standard doses. Feminising hormone therapy options include transdermal or oral estradiol. Additional anti-androgen therapy with cyproterone acetate or spironolactone is typically required. Treatment should be adjusted to clinical response. For biochemical monitoring, target estradiol and testosterone levels in the reference range of the affirmed gender. Monitoring is suggested for adverse effects of hormone therapy. Preferred names in use and pronouns should be used during consultations and reflected in medical records. While being TGD is not a mental health disorder, individualised mental health support to monitor mood during medical transition is recommended. Gender-affirming hormone therapy is effective and, in the short term, relatively safe with appropriate monitoring. Further research is needed to guide clinical care and understand long term effects of hormonal therapies. We provide the first guidelines for medical practitioners to aid the provision of gender-affirming care for Australian adult TGD individuals.
DOI: 10.5694/mja2.50259
ORCID: 0000-0003-3933-5708
Journal: Medical Journal of Australia
PubMed URL: 31271465
Type: Journal Article
Subjects: Endocrine system
Appears in Collections:Journal articles

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