Transgender hormone therapy , also sometimes called sex hormone therapy , is a form of hormone replacement therapy (HRT) in which sex hormones and other hormonal drugs are given to transgender or sex individuals for the purpose of further aligning their secondary sexual characteristics with their gender identity. This form of HRT is given as one of two types, based on whether the goal of care is feminization or masculinization:
- Feminine hormone therapy - for transgender women or transfeminine people; consisting of estrogen and antiandrogen
- Masculinizing hormone therapy - for transgender men or transmasculine men; consist of androgens
Some intersex people can also undergo HRT, either starting in childhood to confirm the gender they are assigned at birth, or later to align their gender with their gender identity. Non-binary or gender people can also undergo HRT to achieve the desired sex hormone balance.
Video Transgender hormone therapy
Requirements
The formal requirements for hormone replacement therapy vary widely.
The Standard of Care for Transsexual, Transgender, and Gender Nonconforming People (SOC) requires psychological counseling and for patients to undergo a period of time in the desired gender role, to ensure that they can function psychologically in the role of gender. This period is sometimes called the real-life experience (RLE). While this standard was widely followed in the 20th century, more and more doctors refused to follow the Standards of Care, insisting that they were too restrictive and that impeding patients' access to hormone therapy was more dangerous than good.
Some LGBT health organizations (especially the Howard Brown Health Center in Chicago) advocate an informed consent model in which patients only have to prove that they understand the risks and agree to the procedure for accessing hormone therapy.
Some people choose to manage their own medicine ("do it yourself") because they do not have access to adequate medical care (neither the available doctors have the necessary experience or the patient is unable to afford treatment since the transitional procedures are so expensive and infrequent is covered by health insurance, but self-regulation of hormones is potentially dangerous Individuals who seek knowledgeable and willing doctors to treat transgender patients may wish to consult a transgender support group or the LGBT-friendly doctor directory.
The World Professional Association for Transgender Health (WPATH) recommends that individuals meet two sets of criteria - eligibility and readiness - to undertake any transition phase, including hormone replacement therapy.
Security
Hormone therapy for transgender individuals has been shown in the medical literature to be safe, when supervised by a qualified medical professional.
Feasibility
Eligibility is determined using the key diagnostic tools, such as ICD-10 or Mental Disorders Manual Diagnostics and Statistics (DSM).
ICD-10
The ICD-10 system requires patients to have a diagnosis of transsexualism or a disturbance of childhood gender identity. Criteria for transsexualism include:
- Transsexual identity for more than two years
- A strong and persistent desire to live as a member of the opposite sex, usually accompanied by a desire to make a person's body aligned with possible sex through surgery and hormone care
Individuals can not be diagnosed with transsexualism if their symptoms are believed to result from other mental disorders, or genetic or chromosomal abnormalities.
For a child diagnosed with a childhood gender identity disorder based on ICD-10 criteria, they must be pre-puberty and have a strong and persistent hardship about being the opposite sex. Tribulation must be present for at least six months. The child should be good :
- Have a preoccupation with stereotypical activities of the opposite sex - as shown by cross-dressing, simulating the opposite sex suit, or a strong desire to join in games and entertainment of the opposite sex - and reject the stereotype of games and entertainment of the sex same, or
- Have a persistent refusal with regards to their anatomy. This can be demonstrated through the belief that they will grow into the opposite sex, that their genitals are disgusting or will be lost, or that it is better not to have their genitals.
DSM
DSM-IV-R listed four main criteria for the diagnosis of gender identity disorder, and also recommended that practitioners study patient sexuality.
- Strong and persistent cross-gender identity : Adolescents and adults should demonstrate a constant desire to be another gender, often graduate as another gender, desire to live or treated as other sex, or believe that they have typical feelings and reactions from the other sex. In children, cross-gender identities can be demonstrated by meeting the following criteria:
- An insistence that someone wants to be the other gender.
- Children looking for male-to-female transitions should display a preference for cross-dressing or simulating women's clothing, and those looking for a female-to-male transition should constantly wear stereotyped men's clothing.
- Continuous ideas for being another gender, or a strong and persistent preference for sex-cross role in make-believe games.
- A strong desire to participate in stereotypical games of the other sex.
- Inconsistent inconvenience with their gender or sense of inaccuracy in the sex roles of that sex . In children, this may involve disgust with the penis or testicles, or the belief that they will disappear. In adults and adolescents, it may manifest as preoccupation with eliminating the characteristics of primary or secondary sex through surgery or hormone replacement therapy.
- Disruptions should not coincide with physical intersex conditions .
- Disorders should cause clinically significant disturbance or damage in the social, work, or other important areas of work .
The DSM-V replaces the term gender identity disorder with gender dysphoria to avoid the implication that gender inequality itself is a mental disorder, but keeps entries so individuals can still seek treatment. The DSM-V, unlike DSM-IV and ICD-10, separates the gender dysphoria from sexual paraphilias and diagnoses it based on a firm belief that a person has a distinctive feeling of another gender, or a strong desire to be treated as another sex or free of characteristic sex someone.
Readiness
The second requirement for hormone replacement therapy is readiness. This means that patients tend to take hormones in a responsible way; has made progress in addressing other identified issues, leading to a steady improvement or mental health; and have consolidated gender identity through psychotherapy or life experience in desired gender roles.
Some organizations - but fewer than in the past - require, based on guidelines such as the Transcendental, Transgender and Gender Nonconforming Standards for Transcendental, Transgender and Gender Health, that patients spend a certain period of time living in the gender roles they want before starting hormone replacement therapy. This period is sometimes called the real-life experience (RLE). The Endocrine Society declared in 2009 that individuals should be documented three months of RLE or undergo psychotherapy for the duration specified by their mental health provider, usually at least three months.
Transgender and gender disloyal activists, such as Kate Bornstein, have asserted that RLE is psychologically harmful and a form of "goalkeeper", effectively blocking individuals from transition as long as possible, if not permanently.
Maps Transgender hormone therapy
Accessibility
Some transgender people choose to use their own hormone replacement drugs, often because doctors have too little experience in this field, or because there are no doctors available. Others set themselves up because their doctors will not prescribe hormones without a letter from a psychotherapist stating that the patient meets the diagnostic criteria and makes the decision to transition. Many therapists need at least three months of ongoing psychotherapy and/or real-life experiences before they write such a letter. Because many people have to pay for evaluation and care, the cost can be expensive.
Access to medicines can be worse even when health care is given free. In a patient survey conducted by the UK National Health Service in 2008, 5% of respondents acknowledged the use of self-medication, and 46% were dissatisfied with the amount of time required to receive hormone therapy. The report concludes in part: "The NHS should provide accessible services so that vulnerable patients do not feel compelled to switch to DIY solutions such as buying drugs online with all the risks required.Patients should be able to access professionals, help and advice so that they can make decisions based on information about their care, whether they want to take NHSs or private routes without putting their health and indeed their lives in jeopardy. "Self-administration of hormone replacement drugs may have unwanted health effects and risks.
See also
- Hormone therapy
- Sex change operation
References
Source of the article : Wikipedia
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