Endocrine Abstracts

Introduction: The incidence of people presenting to gender services is increasing rapidly the case load appears to double every 5 years.This equates to a an estimated incidence of between 1:7440(10) to 1:30,000 for natal males and 1:31,153(10) to 1:10000 for natal females making this a relatively common disorder. The aim of therapy is threefold to suppress the production of the natal sex steroids, provide sufficient hormone levels for the development of the secondary sexual characteristics of the desired gender and finally in the longer term to prevent the consequences of hypogonadism following gonadectomy. Hormone therapy is undertaken in the context of a multidisciplinary team who assess and diagnose the gender dysphoria psychologically and advise on the suitability of the individual for treatment. For Trans women oestradiol valarate in increaseing dose to achieve follicular phase oestradiol levels in combination with a GnRH analogue is the mainstay of hormone treatement.The major risk of oestrogen therapy, as in natal females, is that of thromboembolism. For Transmen the use of standard male testosterone therapy is usually sufficient to suppress ovarian function without the need for a GnRH analogue. The current data suggest that long-term treatment with testosterone in transmen is not associated with any increased risk of cardiovascular disease and the standard mortality ratio of this patient population is one, which is to say there is no increase in mortality. Hormonal therapy being continued lifelong and the target levels for that hormone replacement are the same as for the general male population. I will also discuss the treatment of non-binary people.

Key learning points: Indications for treatment, Effects of cross sex hormone therapy in both genders, Side effects of therapy, Aims and monitoring of cross sex hormone treatment, Long term outcomes, Common regimens used.