Document Detail


Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline.
MedLine Citation:
PMID:  19509099     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim was to formulate practice guidelines for endocrine treatment of transsexual persons. EVIDENCE: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence, which was low or very low. CONSENSUS PROCESS: Committees and members of The Endocrine Society, European Society of Endocrinology, European Society for Paediatric Endocrinology, Lawson Wilkins Pediatric Endocrine Society, and World Professional Association for Transgender Health commented on preliminary drafts of these guidelines. CONCLUSIONS: Transsexual persons seeking to develop the physical characteristics of the desired gender require a safe, effective hormone regimen that will 1) suppress endogenous hormone secretion determined by the person's genetic/biologic sex and 2) maintain sex hormone levels within the normal range for the person's desired gender. A mental health professional (MHP) must recommend endocrine treatment and participate in ongoing care throughout the endocrine transition and decision for surgical sex reassignment. The endocrinologist must confirm the diagnostic criteria the MHP used to make these recommendations. Because a diagnosis of transsexualism in a prepubertal child cannot be made with certainty, we do not recommend endocrine treatment of prepubertal children. We recommend treating transsexual adolescents (Tanner stage 2) by suppressing puberty with GnRH analogues until age 16 years old, after which cross-sex hormones may be given. We suggest suppressing endogenous sex hormones, maintaining physiologic levels of gender-appropriate sex hormones and monitoring for known risks in adult transsexual persons.
Authors:
Wylie C Hembree; Peggy Cohen-Kettenis; Henriette A Delemarre-van de Waal; Louis J Gooren; Walter J Meyer; Norman P Spack; Vin Tangpricha; Victor M Montori;
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Publication Detail:
Type:  Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't     Date:  2009-06-09
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  94     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-07     Completed Date:  2009-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3132-54     Citation Subset:  AIM; IM    
Affiliation:
The Endocrine Society, 8401 Connecticut Avenue, Suite 900, Chevy Chase, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Bone Density
Evidence-Based Medicine
Female
Gender Identity
Gonadal Steroid Hormones / blood,  therapeutic use*
Gonadotropin-Releasing Hormone / analogs & derivatives,  therapeutic use
Humans
Male
Puberty
Transsexualism / complications,  drug therapy*
Venous Thromboembolism / etiology
Chemical
Reg. No./Substance:
0/Gonadal Steroid Hormones; 33515-09-2/Gonadotropin-Releasing Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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