TY - JOUR
T1 - Endocrine treatment of transsexual persons
T2 - An endocrine society clinical practice guideline
AU - Hembree, Wylie C.
AU - Cohen-Kettenis, Peggy
AU - Delemarre-Van De Waal, Henriette A.
AU - Gooren, Louis J.
AU - Meyer, Walter J.
AU - Spack, Norman P.
AU - Tangpricha, Vin
AU - Montori, Victor M.
N1 - Funding Information:
Co-sponsoring Associations: European Society of Endocrinology (ESE), European Society of Pediatric Endocrinology (ESPE), Lawson Wilkins Pediatric Endocrine Society (LWPES), and World Professional Association for Transgender Health (WPATH). Financial Disclosures of Task Force members: Wylie C. Hembree, M.D. (chair)—Financial or Business/Organizational Interests: Columbia University, New York Presbyterian Hospital; Significant Financial Interest or Leadership Position: Sperm Bank of New York. Peggy Cohen-Kettenis, Ph.D.—Financial or Business/Organizational Interests: none declared; Significant Financial Interest or Leadership Position: WPATH. Henriette A. Delemarre-van de Waal, M.D., Ph.D.—Financial or Business/Organizational Interests: none declared; Significant Financial Interest or Leadership Position: none declared. Louis J. Gooren, M.D., Ph.D.—Financial or Business/Organizational Interests: none declared; Significant Financial Interest or Leadership Position: none declared. Walter J. Meyer III, M.D.—Financial or Business/Organizational Interests: WPATH; Significant Financial Interest or Leadership Position: University of Texas Medical Branch, WPATH. Norman P. Spack, M.D.—Financial or Business/Organizational Interests: LWPES, American Diabetes Association; Significant Financial Interest or Leadership Position: none declared. Vin Tangpricha, M.D., Ph.D.—Financial or Business/Organizational Interests: Auxillium, Novartis, National Institutes of Health; Significant Financial Interest or Leadership Position: none declared.* Victor M. Montori, M.D.—Financial or Business/Organizational Interests: KER Unit (Mayo Clinic); Significant Financial Interest or Leadership Position: none declared. *Evidence-based reviews for this guideline were prepared under contract with The Endocrine Society.
PY - 2009/9
Y1 - 2009/9
N2 - Objective: The aim was to formulate practice guidelines for endocrine treatment oftranssexual 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.
AB - Objective: The aim was to formulate practice guidelines for endocrine treatment oftranssexual 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.
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U2 - 10.1210/jc.2009-0345
DO - 10.1210/jc.2009-0345
M3 - Article
C2 - 19509099
AN - SCOPUS:69949085361
SN - 0021-972X
VL - 94
SP - 3132
EP - 3154
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 9
ER -