Current approaches to gender dysforia management: an endocrinologist’s perspective

Understanding of people with impaired gender identity in society, academic and science world is constantly changing due to increased awareness, openness and availability of the information on transgender people and their life. It is known that the social and psychological state of transgenders depends at a great extent on the quality of their medical care, including hormonal treatment. Unfortunately, until recently the awareness of this problem among many physicians (clinical psychologists, psychiatrists, endocrinologists, etc.) in the Russian Federation remained insufficient, and no unified standards of medical and psychological care for transgender people in Russia have been developed. As a result, when referring to various specialists, people with impaired gender identity commonly do not receive adequate recommendations and proper comprehensive medical follow-up. An endocrinologist, who prescribes hormonal treatment and performs long-term (usually life-long) follow-up and monitoring of adverse events, is one of the key team members to provide medical care to transgender patients. The article presents current views on definitions, diagnostic criteria and principles of endocrine therapy for gender dysphoria and gender incongruence, as well as highlights medical risks, associated with hormonal treatment, and a monitoring plan for patients receiving corrective therapy.