Management of transgenderism
- PMID:23385274
- DOI: 10.1001/jama.2012.165234
Management of transgenderism
Abstract
Gender identity disorder (transgenderism) is poorly understood from both mechanistic and clinical standpoints. Awareness of the condition appears to be increasing, probably because of greater societal acceptance and available hormonal treatment. Therapeutic options include hormone and surgical treatments but may be limited by insurance coverage because costs are high. For patients seeking male-to-female (MTF) change, hormone treatment includes estrogens, finasteride, spironolactone, and gonadotropin-releasing hormone (GnRH) analogs. Surgical options include feminizing genital and facial surgery, breast augmentation, and various fat transplantations. For patients seeking a female-to-male (FTM) gender change, medical therapy includes testosterone and GnRH analogs and surgical therapy includes mammoplasty and phalloplasty. Medical therapy for both FTM and MTF can be started in early puberty, although long-term effects are not known. All patients considering treatment need counseling and medical monitoring.
Comment in
- Care for transgender persons.Danoff A, Daskalakis D, Aberg JA.Danoff A, et al.JAMA. 2013 May 22;309(20):2092-3. doi: 10.1001/jama.2013.4662.JAMA. 2013.PMID:23695473No abstract available.
- Care for transgender persons.Lawrence AA, Zucker KJ.Lawrence AA, et al.JAMA. 2013 May 22;309(20):2093. doi: 10.1001/jama.2013.4665.JAMA. 2013.PMID:23695474No abstract available.
- Care for transgender persons--reply.Spack NP.Spack NP.JAMA. 2013 May 22;309(20):2093-4. doi: 10.1001/jama.2013.4668.JAMA. 2013.PMID:23695475No abstract available.
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