Endocrine treatment of transsexual persons

An endocrine society clinical practice guideline

Wylie C. Hembree, Peggy Cohen-Kettenis, Henriette A. Delemarre-Van De Waal, Louis J. Gooren, Walter Meyer, Norman P. Spack, Vin Tangpricha, Victor M. Montori

Research output: Contribution to journalArticle

578 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3132-3154
Number of pages23
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number9
DOIs
StatePublished - Sep 2009

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Transgender Persons
Gonadal Steroid Hormones
Practice Guidelines
Health
Mental Health
Transsexualism
Hormones
Guidelines
Committee Membership
Therapeutics
Puberty
Biological Products
Gonadotropin-Releasing Hormone
Consensus
Reference Values
Monitoring

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Hembree, W. C., Cohen-Kettenis, P., Delemarre-Van De Waal, H. A., Gooren, L. J., Meyer, W., Spack, N. P., ... Montori, V. M. (2009). Endocrine treatment of transsexual persons: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 94(9), 3132-3154. https://doi.org/10.1210/jc.2009-0345

Endocrine treatment of transsexual persons : An endocrine society clinical practice guideline. / Hembree, Wylie C.; Cohen-Kettenis, Peggy; Delemarre-Van De Waal, Henriette A.; Gooren, Louis J.; Meyer, Walter; Spack, Norman P.; Tangpricha, Vin; Montori, Victor M.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 94, No. 9, 09.2009, p. 3132-3154.

Research output: Contribution to journalArticle

Hembree, WC, Cohen-Kettenis, P, Delemarre-Van De Waal, HA, Gooren, LJ, Meyer, W, Spack, NP, Tangpricha, V & Montori, VM 2009, 'Endocrine treatment of transsexual persons: An endocrine society clinical practice guideline', Journal of Clinical Endocrinology and Metabolism, vol. 94, no. 9, pp. 3132-3154. https://doi.org/10.1210/jc.2009-0345
Hembree WC, Cohen-Kettenis P, Delemarre-Van De Waal HA, Gooren LJ, Meyer W, Spack NP et al. Endocrine treatment of transsexual persons: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2009 Sep;94(9):3132-3154. https://doi.org/10.1210/jc.2009-0345
Hembree, Wylie C. ; Cohen-Kettenis, Peggy ; Delemarre-Van De Waal, Henriette A. ; Gooren, Louis J. ; Meyer, Walter ; Spack, Norman P. ; Tangpricha, Vin ; Montori, Victor M. / Endocrine treatment of transsexual persons : An endocrine society clinical practice guideline. In: Journal of Clinical Endocrinology and Metabolism. 2009 ; Vol. 94, No. 9. pp. 3132-3154.
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