Prescribing for transgender patients

With greater awareness and social acceptance, increasing numbers of transgender individuals are presenting for gender-affirming hormone treatment. There should be a full psychosocial assessment by an experienced clinician before hormone treatment is considered. People assigned as males at birth who transition to female gender are transgender females. Their management includes an estrogen plus an anti-androgen. People assigned as females at birth who transition to male gender are transgender males. Their hormone treatment is testosterone. Treatment is titrated so that hormone concentrations are equivalent to the physiological concentrations of the preferred gender. This aims to minimise adverse effects.