title: Is physical examination required before prescribing hormones to patients with gender dysphoria?
abstract: BACKGROUND
  A genital examination can have psychologic effects on a patient, particularly when the source of their sexual medicine complaint is a body part. How necessary is a physical exam before prescribing hormones in cases of gender dsyphoria?
  
  
  METHODS
  Five people with expertise and/or interest in the area of gender dysphoria and endocrinology were asked to contribute their opinions.
  
  
  METHODS
  To provide food for thought, discussion, and possible further research in a poorly discussed area of sexual medicine.
  
  
  RESULTS
  Of the five experts writing on the topic, one believes that a physical examination should always be performed before prescribing hormones for gender dysphoria, one believes it is not a prerequisite, and three believe a physical examination is recommended, but is not necessary in cases where the patient objects despite an explanation of the purpose of the exam. As long as this was documented, it would not present a medicolegal problem.
  
  
  CONCLUSIONS
  It is not clear whether or not a physical examination must be performed on all gender dsyphoric patients before prescribing hormones; however, an examination would be helpful in revealing a significant health management issue.
authors.affiliation: Department of Neuro-Urology, Rambam Medical Center, Haifa, Israel. yvardi@rambam.health.gov.il
authors.forename: Yoram
authors.initials: Y
authors.lastname: Vardi
authors.forename: Kevan R
authors.initials: KR
authors.lastname: Wylie
authors.forename: Charles
authors.initials: C
authors.lastname: Moser
authors.forename: Pierre
authors.initials: P
authors.lastname: Assalian
authors.forename: John
authors.initials: J
authors.lastname: Dean
authors.forename: Henk
authors.initials: H
authors.lastname: Asscheman
mesh_terms: D002983:Clinical Competence; D005260:Female; D005783:Gender Identity; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008487:Medical History Taking; D011788:Quality of Life; D019529:Sexuality; D014189:Transsexualism / Q000188:drug therapy*; D014190:Transvestism / Q000188:drug therapy*
chemical_list: D012739:Gonadal Steroid Hormones