Whatever route an individual and their doctor choose to take, it is important to consider both the medical risks of hormone therapy as well as the psychological needs of the patient. Most parents start off feeling their child is too young to know with any certainty something as momentous as being transgender. Second, this arm of the WHI involved the use of conjugated equine estrogens in combination with medroxyprogesterone in a sample of menopausal women, some of whom were as long as 10 years post-menopausal at the time of hormone initiation. Steroidal antiandrogens are antiandrogens that resemble steroid hormones like testosterone and progesterone in chemical structure. While manipulation of dosing regimens and choice of medication can allow patients to achieve this goal, it is important to have a clear discussion with patients regarding expectations and unknowns. World Journal of Urology.
Raising the dosage of estrogen or adding a progestogen raises the libido of some transgender women.
Hormone therapy for transgender patients
Many other common interventions such as contraception or HIV pre-exposure prophylaxis do not involve the use of consent forms, and rely on a discussion and shared decision making between patient and provider. In addition, if a patient is at significant risk for osteoporosis, a baseline bone mineral density should be obtained 9. Maintaining estrogen levels in the physiologic range for menstruating non-transgender women minimizes risks and side effects, and makes sense clinically. This period is sometimes called real-life experience RLE. Horm Mol Biol Clin Investig. Recently, an attempt has been made by Foss to initiate lactation in a castrated male transvestist.
Specifically, it is not possible to select in advance an exact hormone regimen that will predictably allow patients to arrive at a specified configuration of sex characteristics. GnRH analogs are used routinely in the care of peripubertal transgender youth who require pubertal delay, and have been described in the care of transgender adults as well. Figures describe the approach to various scenarios of VTE history or risk factors and estrogen use. Regarding ethical responsibilities, it is crucial that counselors are aware of, confront and alter their own biases, fears transphobiadiscomfort, gender-normative assumptions and lack of information about transgender persons. Over time, most families can work together, honoring both of these values and arriving at a good outcome.