Care of transgender persons
JD Safer, V Tangpricha - New England Journal of Medicine, 2019 - Mass Medical Soc
New England Journal of Medicine, 2019•Mass Medical Soc
Key Clinical Points Care of Transgender Persons Survey data indicate that approximately
0.6% of the US population identifies as transgender. No medical intervention is indicated
before puberty. When puberty begins, reversible therapy with a gonadotropin-releasing
hormone agonist can delay puberty until a long-term treatment plan can be established. For
transgender men, testosterone can be administered to achieve testosterone levels in the
male range. For transgender women, estrogens lower testosterone levels through central …
0.6% of the US population identifies as transgender. No medical intervention is indicated
before puberty. When puberty begins, reversible therapy with a gonadotropin-releasing
hormone agonist can delay puberty until a long-term treatment plan can be established. For
transgender men, testosterone can be administered to achieve testosterone levels in the
male range. For transgender women, estrogens lower testosterone levels through central …
Key Clinical Points
Care of Transgender Persons
- Survey data indicate that approximately 0.6% of the U.S. population identifies as transgender.
- No medical intervention is indicated before puberty. When puberty begins, reversible therapy with a gonadotropin-releasing hormone agonist can delay puberty until a long-term treatment plan can be established.
- For transgender men, testosterone can be administered to achieve testosterone levels in the male range.
- For transgender women, estrogens lower testosterone levels through central suppression of the reproductive axis while having feminizing effects and protecting bone health.
- In transgender women, estrogen therapy is associated with an increased risk of venous thromboembolism. Concomitant treatment of transgender women with androgen-lowering agents (e.g., spironolactone) allows for administration of lower doses of exogenous estrogen.
- Surgery choice should be customized to patient goals, with consideration of associated risks and the patient’s interest in fertility.
The New England Journal Of Medicine