Endocrine Treatment of Transsexual Persons – A Patient’s Guide

In 1923, the term transsexual was first used to describe persons who felt profound discomfort with their biological sex. Today, medical treatment, sometimes together with surgery, allows transsexual persons to make a male-to-female (MTF) or female-to-male (FTM) transition and to live a gender-appropriate life.

This is the patient guide that was released at the same time as the “Endocrine Treatment
of Transsexual Persons”.

Dated September 2009.

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Endocrine Treatment of Transsexual Persons

The aim was to formulate practice guidelines for endocrine treatment of transsexual persons by medical practitioners, endocrinologists, surgeons, psychiatrists, and General Practitioners. This is the current version even though it is dated 2009.

First published in the Journal of Clinical Endocrinology & Metabolism, September 2009, 94(9): 3132–3154

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UK Hormones 2005

A comprehensive document of 96 pages about hormonal regimes, the drugs used, their benefits, and their side-effects. Plus the emergency situations that they can cause. Updated, well indexed and with new content.

Update – I am currently rewriting this, and its provisional title is “Universal Hormones – 2014″, which should be published later on this year.

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Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria.


Cross-sex hormonal treatment (CHT) used for gender dysphoria (GD) could by itself affect well-being without the use of genital surgery; however, to date, there is a paucity of studies investigating the effects of CHT alone.


This study aimed to assess differences in body uneasiness and psychiatric symptoms between GD clients taking CHT and those not taking hormones (no CHT). A second aim was to assess whether length of CHT treatment and daily dose provided an explanation for levels of body uneasiness and psychiatric symptoms.


A consecutive series of 125 subjects meeting the criteria for GD who not had genital reassignment surgery were considered.

Main outcome measures

Subjects were asked to complete the Body Uneasiness Test (BUT) to explore different areas of body-related psychopathology and the Symptom Checklist-90 Revised (SCL-90-R) to measure psychological state. In addition, data on daily hormone dose and length of hormonal treatment (androgens, estrogens, and/or antiandrogens) were collected through an analysis of medical records.


Among the male-to-female (MtF) individuals, those using CHT reported less body uneasiness compared with individuals in the no-CHT group. No significant differences were observed between CHT and no-CHT groups in the female-to-male (FtM) sample. Also, no significant differences in SCL score were observed with regard to gender (MtF vs. FtM), hormone treatment (CHT vs. no-CHT), or the interaction of these two variables. Moreover, a two-step hierarchical regression showed that cumulative dose of estradiol (daily dose of estradiol times days of treatment) and cumulative dose of androgen blockers (daily dose of androgen blockers times days of treatment) predicted BUT score even after controlling for age, gender role, cosmetic surgery, and BMI.


The differences observed between MtF and FtM individuals suggest that body-related uneasiness associated with GD may be effectively diminished with the administration of CHT even without the use of genital surgery for MtF clients. A discussion is provided on the importance of controlling both length and daily dose of treatment for the most effective impact on body uneasiness.


Fisher AD, Castellini G, Bandini E, Casale H, Fanni E, Benni L, Ferruccio N, Meriggiola MC, Manieri C, Gualerzi A, Jannini E, Oppo A, Ricca V, Maggi M, Rellini AH.


Journal of Sexual Medicine. March 2014; volume 11, number 3: pages 709-19.

Staying Sane and Whole While in Transition.

Tripping the Light Fantastic: Staying Sane and Whole While in Transition

by Dallas Denny

Sex reassignment is one of the most radical and disruptive things that an individual can do. It strains and often severs social relationships, imposes economic hardships, involves a good deal of physical pain and a great deal of psychic pain, and requires study and hard work in order to even begin to hope to pass in the gender of choice. Transition must be pursued in the face of the general disapproval of society and the specific disapproval of loved ones, the reluctance of the medical community to provide services, a scarcity of resources, and countless legal and social obstacles. The body of one sex must be somehow whipped into the semblance of that of the opposite sex, generally after puberty has wreaked irreversible somatic changes. Old behavioural patterns must be unlearned and new ones added. A new life must replace the old.

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Why Suicide Has Become an Epidemic–and What We Can Do to Help

By Tony Dokoupil / May 23, 2013 4:45 AM EDT

When Thomas Joiner was 25 years old, his father—whose name was also Thomas Joiner and who could do anything—disappeared from the family’s home. At the time, Joiner was a graduate student at the University of Texas, studying clinical psychology. His focus was depression, and it was obvious to him that his father was depressed. Six weeks earlier, on a family trip to the Georgia coast, the gregarious 56-year-old—the kind of guy who was forever talking and laughing and bending people his way—was sullen and withdrawn, spending days in bed, not sick or hungover, not really sleeping.

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Caring and transgender people.

Transgender or “trans” are terms used to describe people who don’t conform to the traditional genders of male or female.

“Trans” can include cross-dressers, people who wear a mix of clothing, people with a dual or no gender identity, and transsexual people.

Practicalities for trans carers or carers of trans people

Trans people who live permanently in their preferred gender often face immense difficulties throughout their lives, with family and friends, carers, employers and sometimes government bodies and health and care providers.

Trans people may have particular needs regarding privacy, for example, because they may fear that transitioning to their acquired gender may put their career at risk.

Some who transitioned many years ago “pass” in public life as non-trans people, while others living permanently in their new gender are clearly trans people to those they communicate with.

Trans people often have complex gender identities and assumptions should not be made about an individual’s identity. It is always best to ask if you are not sure.

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Post-op Care.

This file is a transcription of a patient instruction sheet that was distributed by Dr. Michel Seghers of Belgium. It would be typically given out to SRS patients as guidance for follow-up care. It contains specific information about dilation and appears to be of a generic nature based on the inclusion of other surgeon’s names. It is reproduced here to be of an informative nature to pre-operative patients to indicate one aspect of personal care that will have to be incorporated into a daily routine for an indefinite period of time. It is not meant to override the instructions of a specific surgeon that may have different guidelines. The text was distributed in 1992.

After that are some comments that elaborate on items in the text. These are meant to be general in nature and hopefully will be found helpful in learning about one aspect of personal care. They can also provide topics for discussion with professionals when there are any doubts about proper health maintenance.

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