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This condition may cause clinically significant distress or impairment in social, occupational or other important areas of functioning.Gender reassignment surgery is performed to change primary and/or secondary sex characteristics.The criterion noted above for some types of genital surgeries – i.e., that patients engage in 12 continuous months of living in a gender role that is congruent with their gender identity – is based on expert clinical consensus that this experience provides ample opportunity for patients to experience and socially adjust in their desired gender role, before undergoing irreversible surgery (Coleman, et al., 2011).
These investigators reported the experience of one provider with the endocrine treatment of transgender persons over the past 2 decades.
Data on demographics, clinical response to treatment, and psychosocial status were collected on all transgender persons receiving cross-sex hormone therapy since 1991 at the endocrinology clinic at Albany Medical Center, a tertiary care referral center serving upstate New York.
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.
The number of persons seeking treatment has increased substantially in recent years.
Cross-sex hormone therapy achieves very good results in FTM persons and is most successful in MTF persons when initiated at younger ages.
All patients considering treatment need counseling and medical monitoring.
Leinung and colleagues (2013) noted that the Endocrine Society's recently published clinical practice guidelines for the treatment of transgender persons acknowledged the need for further information on transgender health.
The authors concluded that transgender persons seeking hormonal therapy are being seen with increasing frequency.
The dysphoria present in many transgender persons is associated with significant mood disorders that interfere with successful careers.