Transgender Hormonal Therapy

Programs and Disease Treatment

Transgender Hormonal Therapy

A person with gender identity disorder — a recognized medical disorder — feels “trapped” in the wrong body. A person may be born as one sex, but may not identify with this sex.

Transgender men and women desire a permanent identity as a member of the gender with which they identify. This transition usually involves hormonal therapy and may also involve surgery.

Froedtert & The Medical College offer hormonal therapy for transgender individuals. For people seeking transgender surgery, individuals are referred to well-established healthcare facilities that specialize in this procedure.

Hormonal Therapy

We provide expert care at Froedtert & The Medical College of Wisconsin. Transgender hormonal therapy (also called hormonal reassignment) is offered to individuals to:

Allow development of secondary sexual characteristics that reflect the preferred gender identity
Monitor safety and efficacy of therapy

Hormonal therapy for transgender people replaces the hormones naturally occurring in their bodies with those of the other sex.

Female-to-male hormonal treatment (testosterone treatment) is provided to promote male characteristics, such as a male pattern of sexual hair, a male voice and a male physical shape. The treatment also results in stopping monthly menstruation.
Male-to-female hormonal treatment is provided to inhibit male characteristics and promote feminine characteristics, such as breast formation and elimination of sexual hair growth.

Both male hormones (androgens) and female hormones (estrogens) are present in both males and females alike, but in vastly different amounts. Giving the right amount of the right hormone is important in the life-long management of transgender hormonal therapy.

Psychological Evaluation

To obtain sex reassignment therapy, a full psychological or psychiatric evaluation by a certified professional will be performed prior to the start of hormonal therapy. This is important to ensure that the diagnosis of transgender re-assignment is not clouded by an underlying psychiatric disorder. Individuals may obtain their own professional evaluation in the community or through professionals at Froedtert & The Medical College of Wisconsin.

A local resource, a Milwaukee transgender program called Pathways, (pathwayscounseling.com), offers professional and supportive programs dealing with issues of gender identity. Pathways also offers psychiatric evaluations to program participants as well as information, guidance about resources and peer group support.

Therapy Based on Guidelines

Once the psychological evaluation is completed, outpatient hormonal therapy and management can be given.

Initial care includes a physical exam to check the individual’s overall health as well as blood work. Hormonal therapy is geared to an individual’s goals and therapy is monitored by clinical response as well as by blood work. Therapies are adjusted as needed based on response. Hormones are given as oral and/or injectable medications.

Therapy is based on care standard guidelines established by The Endocrine Society called Endocrine Treatment of Transsexual Persons. The guidelines were developed by a task force of content experts and co-sponsored by the European Society of Endocrinology, European Society of Pediatric Endocrinology, Lawson Wilkins Pediatric Endocrine Society, and the World Professional Association for Transgender Health. The guidelines address treatment of adolescents, hormonal therapy for transsexual adults, long-term care and sex re-assignment surgery.

People who desire transgender hormonal therapy are encouraged to see a trained medical professional, who will prescribe the right medications and monitor your care over time. The physician carefully watches for complications as you slowly begin taking an increasing level of hormones.

The risks of transgender hormonal therapy are same as the risks for anyone on hormonal therapy. For example, a man receiving estrogen therapy has the same increased risk of thromboembolism, stroke or breast cancer as a woman who takes birth control pills. Screening for breast cancer and other risks are built into the care guidelines. Monitoring for these risk factors is part of the clinical care.

Physicians throughout Wisconsin refer their patients to Froedtert & The Medical College of Wisconsin for transgender hormonal therapy. We share our expertise with the community physicians so they can continue local care for their patients.

Last Review Date: Aug. 25, 2009