Progress on the road to better medical care for transgender patients.
OBJECTIVE
In order to improve transgender individuals' access to healthcare, primary care physicians and specialists alike should be knowledgeable about transgender medicine. This review is intended to provide concise transgender hormone treatment guidelines.


RESULTS
Transgender individuals report that the lack of knowledgeable providers represents the greatest barrier to transgender medical care. Hormone treatments are generally well tolerated and greatly benefit transgender patients. After physicians recognize that gender identity is stable, hormone treatments for transgender patients are often straightforward. A practical target for hormone therapy for transgender men (female to male) is to increase testosterone levels to the normal male physiological range (300-1000 ng/dl) by administering testosterone. A practical target for hormone therapy for transgender women (male to female) is to decrease testosterone levels to the normal female range (30-100 ng/dl) without supra-physiological levels of estradiol (<200 pg/ml) by administering an antiandrogen and estrogen. Patients should be monitored every 3 months for the first year and then every 6-12 months for hormonal effects.


CONCLUSIONS
Although more studies are required, recently published transgender medical treatment guidelines provide a good start toward making care of transgender patients more generalized and accessible to healthcare providers.
Section of Endocrinology, Boston University School of Medicine, Boston, Massachusetts, USA.
Ivy H
IH
Gardner
Joshua D
JD
Safer
D000726:Androgen Antagonists / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000592:standards; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D062985:Health Services for Transgender Persons / Q000592:standards / Q000639:trends; D054625:Healthcare Disparities; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D036301:Qualitative Research; D013739:Testosterone / Q000627:therapeutic use*; D063106:Transgender Persons
D000726:Androgen Antagonists; D004967:Estrogens; D013739:Testosterone