Endocrine Abstracts

Gender Identity Disorder (GID) has been recognised since the 1950s. The reported prevalence for GID is up to 1 in 30,000 in men and 1 in 100,000 in women. We reviewed 16 patients who were determined to have met the diagnostic criteria for GID and were referred to our clinic for advice on hormonal treatment (HT) - the second phase of the triadic treatment protocol for gender reassignment.
The mean age of the group is 32years (Range 18 to 51years). Thirteen have male to female GID and 3 female to male GID. Five are married and 4 have children. All are undergoing regular psychotherapy and 11 of the 16 are living in role. Ten are from Leinster, 5 from Munster and 1 from Connacht.
Four of the patients have demonstrated features of clinical depression and engaged in self-injurious behaviours with one patient self-administering a unilateral orchidectomy. Five of the 16 had been prescribed HT prior to referral to our clinic, 2 of these paid monthly fees of 800 Euro (500 pounds sterling) for 100 micrograms daily of ethinyloestradiol to overseas clinics. Baseline hormone profiles in those not on HT were normal for their genotypic sex. Three have undergone surgery, though none of the patients has completed full gender reassignment.
Four of the patients were considered unsuitable for HT at first review, one each due to unresolved social issues, uncontrolled hypertension, uncontrolled atrial fibrillation and lack of understanding of the risks of HT. To date, there have been three adverse reactions necessitating withdrawal of HT in the male to female group. One patient suffered an acute psychosis; one developed a left hemiparesis and a third complained of dyspnoea. One female to male patient developed acne but this did not necessitate withdrawal of HT. Twelve patients in our group are currently receiving HT.