Current dilemmas in transgender medicine

Transgender persons increasingly come into focus of the general public. That is not the case for transgender medicine. Only few centers worldwide are dedicated to transgender medicine. Prevalence of gender incongruence is steadily rising with a phenomenal increase during the last decenium. Transgender persons are desperately seeking professional and empathic medical care, both during transition and afterwards. The medical world is not prepared for the big inrush. Neither academic curricula nor specialty training programmes have implemented programmes on transgender healthcare issues. In particular doctors perceive as strange the fact that the goals of medical treatment are beyond medical perspective. Selfdetermined living according one's genderidentity, without suffering from gender dysphoria, and being capable of social interaction under all circumstances, and health maintenance up until old age are the goals. Also implicit transphobia in medicine or the phenomenon of non-binary identities are addressed, and how to cope herewith. This article draws a line along the faultlines of society and medicine. It appears extremely helpful for doctors engaged in transgender healthcare to learn about the social context of transgender persons and gain knowledge about all other specialties involved in transgender medicine.