title: Endocrinologic treatment of gender identity disorders.
abstract: OBJECTIVE
  To review the diagnosis, therapeutic options, and potential complications of treatment of transsexualism.
  
  
  METHODS
  We summarize the appropriate initial assessment and the current guidelines for hormonal and surgical treatment of patients with transsexualism.
  
  
  RESULTS
  The cardinal feature of transsexualism is the permanent feeling of gender dysphoria. As part of the treatment of this condition, patients may seek medical and surgical therapies to change their physical appearance to match their internal gender identity. Cross-sex hormone therapy is a key medical management and is often prescribed in consultation with an endocrinologist. Patients should participate in a period of psychotherapy before such hormonal therapy is initiated. Medical therapies for transsexualism are associated with potentially serious complications, such as thromboembolism related to estrogen treatment and testosterone-induced hepatotoxicity. Patients should be carefully selected for therapy with use of the current management guidelines published by the Harry Benjamin International Gender Dysphoria Association.
  
  
  CONCLUSIONS
  Physicians caring for patients with transsexualism should have a general knowledge about the diagnosis, available treatment, and monitoring for complications of hormonal therapy. Ongoing research and education are necessary for improvement in the health care of these patients.
authors.affiliation: Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Vin
authors.initials: V
authors.lastname: Tangpricha
authors.forename: Stanley H
authors.initials: SH
authors.lastname: Ducharme
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Barber
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Chipkin
mesh_terms: D005260:Female; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D014189:Transsexualism / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*
chemical_list: D012739:Gonadal Steroid Hormones