Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals

Abstract

Introduction: To date no standardized hormonal treatment protocols for non-binary transgender individuals have been described in the literature and there is a lack of data regarding their efficacy and safety.

Objectives: To suggest possible treatment strategies for non-binary transgender individuals with non-standardized requests and to emphasize the importance of a personalized clinical approach.

Methods: A narrative review of pertinent literature on gender-affirming hormonal treatment in transgender persons was performed using PubMed.

Results: New hormonal treatment regimens outside those reported in current guidelines should be considered for non-binary transgender individuals, in order to improve psychological well-being and quality of life. In the present review we suggested the use of hormonal and non-hormonal compounds, which-based on their mechanism of action-could be used in these cases depending on clients' requests.

Conclusion: Requests for an individualized hormonal treatment in non-binary transgender individuals represent a future challenge for professionals managing transgender health care. For each case, clinicians should balance the benefits and risks of a personalized non-standardized treatment, actively involving the person in decisions regarding hormonal treatment.

Keywords: gender-affirming hormonal treatment; non-binary; personalized medicine; transgender.

Figure 1

Flowchart reporting possible treatment options in non-binary transgender individuals. The figure includes hormonal/non-hormonal compounds and other strategies (i.e., procedures and surgical interventions) that could be proposed to non-binary transgender individuals on the basis of their requests. Variable dosages of hormonal compounds are discussed in the text. AMAB: assigned male at birth; AFAB: assigned female at birth; GnRH: gonadotropin-releasing hormone CPA: cyproterone acetate; IUD: intrauterine device.