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Review
. 2018 Oct;6(4):607-617.
doi: 10.1016/j.sxmr.2018.03.006. Epub 2018 Jun 8.

Evaluation and Treatment of Gender Dysphoria to Prepare for Gender Confirmation Surgery

Miriam Hadj-Moussa  1 , Dana A Ohl  2 , William M Kuzon Jr  3
Affiliations
Review

Evaluation and Treatment of Gender Dysphoria to Prepare for Gender Confirmation Surgery

Miriam Hadj-Moussa et al. Sex Med Rev. 2018 Oct.

Abstract

Background: Gender dysphoria is the experience of marked distress due to incongruence between genetically determined gender and experienced gender. Treatment of gender dysphoria should be individualized and multidisciplinary, involving a combination of psychotherapy, social gender transition, cross-sex hormone therapy, gender-affirming surgery, and/or ancillary procedures and services. The goal of all treatment modalities is to alleviate distress and affirm the patient's experienced gender identity. This article is the first in a 3-part series focused on the diagnostic assessment and non-operative treatment of gender dysphoria. Parts 2 and 3 focus on operative aspects of gender dysphoria treatment.

Aim: To summarize the recommendations of the World Professional Association for Transgender Health (WPATH) and the Endocrine Society (ES), as well as review published literature regarding the non-operative treatment of gender dysphoria.

Methods: A review of relevant literature through January 2017 was performed via PubMed.

Outcomes: WPATH guidelines regarding diagnosis and non-surgical treatment of gender dysphoria, specifically regimens and risks of cross-sex hormone therapy were reviewed.

Results: Few physicians have experience with the diagnosis or treatment of gender dysphoria, although the number of patients seeking treatment has risen substantially in recent years. As a result, clinicians have turned to published recommendations from WPATH and ES, both of which promote high-quality, evidence-based care for patients with gender dysphoria. Successful treatment requires an individualized multidisciplinary approach. Non-operative treatment is both safe and effective for the majority of patients with gender dysphoria.

Conclusions: Guidelines from WPATH and ES, along with published literature pertaining to the diagnosis and non-operative treatment of gender dysphoria, were reviewed and summarized. Hadj-Moussa M, Ohl DA, Kuzon WM. Evaluation and Treatment of Gender Dysphoria to Prepare for Gender Confirmation Surgery. Sex Med Rev 2018;6:607-617.

Keywords: Cross-Sex Hormone Therapy; Gender Dysphoria; Real-Life Experience; Transgender.

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