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Gender-affirming hormone therapy
Gender-affirming hormone therapy (GAHT), also called hormone replacement therapy (HRT) or transgender hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:
Eligibility for GAHT may require an assessment for gender dysphoria or persistent gender incongruence; many medical institutions now use an informed consent model, which ensures patients are informed of the procedure process, including possible benefits and risks, while removing many of the historical barriers needed to start hormone therapy. Treatment guidelines for therapy have been developed by several medical associations.[citation needed]
Non-binary people may also engage in hormone therapy in order to achieve a desired balance of sex hormones or to help align their bodies with their gender identities. Many transgender people obtain hormone replacement therapy from a licensed health care provider, while others obtain and self-administer hormones.
The formal requirements to begin gender-affirming hormone therapy vary widely depending on geographic location and specific institution.[citation needed] Gender-affirming hormones can be prescribed by a wide range of medical providers including, but not limited to, primary care physicians, endocrinologists, and gynecologists. Requirements to be prescribed these hormones generally include a minimum age. According to the Endocrine Society, there has been little research on taking cross-sex hormones before the age of about 14.
Historically, many health centers required a psychiatric evaluation and/or a letter from a therapist before beginning hormone replacement therapy. Many centers now use an informed consent model that does not require any routine formal psychiatric evaluation, but rather focuses on reducing barriers to care while ensuring a person can understand the risks and benefits of treatment. Some LGBT health organizations, including Chicago's Howard Brown Health Center and Planned Parenthood, advocate for this type of informed consent model.
The World Professional Association for Transgender Health (WPATH) Standards of Care, 7th edition, note that both of these approaches to care are appropriate.
Many international guidelines and institutions require persistent, well-documented gender dysphoria as a pre-requisite to starting gender-affirmation therapy. Gender dysphoria refers to the psychological discomfort or distress that an individual can experience if their sex assigned at birth is incongruent with that person's gender identity. Signs of gender dysphoria can include comorbid mental health stressors such as depression, anxiety, low self-esteem, and social isolation. Not all gender nonconforming individuals experience gender dysphoria, and measuring a person's gender dysphoria is critical when considering medical intervention for gender nonconformity.
For transgender youth, the Dutch protocol existed as among the earlier guidelines for hormone therapy by delaying puberty until age 16. The World Professional Association for Transgender Health (WPATH) and the Endocrine Society later formulated guidelines that created a foundation for health care providers to care for transgender patients. UCSF guidelines are also sometimes used. There is no generally agreed-upon set of guidelines, however.
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Gender-affirming hormone therapy
Gender-affirming hormone therapy (GAHT), also called hormone replacement therapy (HRT) or transgender hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:
Eligibility for GAHT may require an assessment for gender dysphoria or persistent gender incongruence; many medical institutions now use an informed consent model, which ensures patients are informed of the procedure process, including possible benefits and risks, while removing many of the historical barriers needed to start hormone therapy. Treatment guidelines for therapy have been developed by several medical associations.[citation needed]
Non-binary people may also engage in hormone therapy in order to achieve a desired balance of sex hormones or to help align their bodies with their gender identities. Many transgender people obtain hormone replacement therapy from a licensed health care provider, while others obtain and self-administer hormones.
The formal requirements to begin gender-affirming hormone therapy vary widely depending on geographic location and specific institution.[citation needed] Gender-affirming hormones can be prescribed by a wide range of medical providers including, but not limited to, primary care physicians, endocrinologists, and gynecologists. Requirements to be prescribed these hormones generally include a minimum age. According to the Endocrine Society, there has been little research on taking cross-sex hormones before the age of about 14.
Historically, many health centers required a psychiatric evaluation and/or a letter from a therapist before beginning hormone replacement therapy. Many centers now use an informed consent model that does not require any routine formal psychiatric evaluation, but rather focuses on reducing barriers to care while ensuring a person can understand the risks and benefits of treatment. Some LGBT health organizations, including Chicago's Howard Brown Health Center and Planned Parenthood, advocate for this type of informed consent model.
The World Professional Association for Transgender Health (WPATH) Standards of Care, 7th edition, note that both of these approaches to care are appropriate.
Many international guidelines and institutions require persistent, well-documented gender dysphoria as a pre-requisite to starting gender-affirmation therapy. Gender dysphoria refers to the psychological discomfort or distress that an individual can experience if their sex assigned at birth is incongruent with that person's gender identity. Signs of gender dysphoria can include comorbid mental health stressors such as depression, anxiety, low self-esteem, and social isolation. Not all gender nonconforming individuals experience gender dysphoria, and measuring a person's gender dysphoria is critical when considering medical intervention for gender nonconformity.
For transgender youth, the Dutch protocol existed as among the earlier guidelines for hormone therapy by delaying puberty until age 16. The World Professional Association for Transgender Health (WPATH) and the Endocrine Society later formulated guidelines that created a foundation for health care providers to care for transgender patients. UCSF guidelines are also sometimes used. There is no generally agreed-upon set of guidelines, however.