Groundbreaking research presented at the 71st AACC Annual Scientific Meeting & Clinical Lab Expo has revealed how transgender hormone therapy affects the results of common laboratory tests in the long term. This first-of-its-kind study could enable the development of transgender-specific reference intervals, which are crucial to ensuring that transgender patients get accurate diagnoses and equitable healthcare.
Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care.
In the most comprehensive review to date addressing the relative safety of hormone therapy for transgender persons, researchers have found that hormone therapy in transgender adults is safe. The findings may help reduce the barriers for transgender individuals to receive medical care.
“Objectives: To review evidence from prospective cohort studies of the relationship between hormone therapy and changes in psychological functioning and quality of life in transgender individuals accessing hormone therapy over time.
Data Sources: MEDLINE, PsycINFO, and PubMed were searched for relevant studies from inception to November 2014. Reference lists of included studies were hand searched.
Results: Three uncontrolled prospective cohort studies, enrolling 247 transgender adults (180 male-to-female [MTF], 67 female-to-male [FTM]) initiating hormone therapy for the treatment of gender identity disorder (prior diagnostic term for gender dysphoria), were identified. The studies measured exposure to hormone therapy and subsequent changes in mental health (e.g., depression, anxiety) and quality of life outcomes at follow-up. Two studies showed a significant improvement in psychological functioning at 3–6 months and 12 months compared with baseline after initiating hormone therapy. The third study showed improvements in quality of life outcomes 12 months after initiating hormone therapy for FTM and MTF participants; however, only MTF participants showed a statistically significant increase in general quality of life after initiating hormone therapy.
Conclusions: Hormone therapy interventions to improve the mental health and quality of life in transgender people with gender dysphoria have not been evaluated in controlled trials. Low quality evidence suggests that hormone therapy may lead to improvements in psychological functioning. Prospective controlled trials are needed to investigate the effects of hormone therapy on the mental health of transgender people.”
To cite this article:White Hughto Jaclyn M. and Reisner Sari L.. Transgender Health. January 2016, 1(1): 21-31. doi:10.1089/trgh.2015.0008.
Published in Volume: 1 Issue 1: January 13, 2016
Jaclyn M. White Hughto1,2,* and Sari L. Reisner1,3,41The Fenway Institute, Fenway Health, Boston, Massachusetts.2Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.3Division of General Pediatrics, Boston Children’s Hospital/Harvard Medical School, Boston, Massachusetts.4Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.*Address correspondence to: Jaclyn M. White Hughto, MPH, The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, E-mail: JWhite@FenwayHealth.org
“Yet there have been few studies looking at the long-term effects of HRT. While observational studies have retrospectively reviewed trans populations and declared hormonal transition to be safe, trans medicine has not had the kind of clinical research that is typically conducted for lifesaving medicine. There are medical guidelines for trans health care issued by organizations like the Endocrine Society and the World Professional Association for Transgender Health, but there are also unknowns — questions that neither patients nor physicians can answer.”
Beginning this month my local Planned Parenthood has begun to offer services to the transgender community. On August 31st they and our local support group will be holding an informational meeting which I have indicated I plan on attending.
Naturally I have spent the last several weeks since the initial announcement going from being firm in my resolve to take this step in my transition to trying to convince myself not to go. All of my usual overthinking combined with depression, anxiety, and dysphoria have created a toxic mix which has left me exhausted. Unable to sleep well, eat well, and doing my damnedest to avoid alcohol (a crutch I have kicked once already).
After all these years I know I have reached the point where I need to take this step to survive and that trying to hold off until I am near the breaking point will do nothing more than make me suffer a great deal of pain I don’t need or deserve… (Of course knowing this has never stopped me before)…
I swear, something inside insists I deserve to suffer. That I do not, nor have I ever had the right to experience true happiness.
The heartbreaking part is knowing in hurting myself I also hurt those I love the most.
None the less, such knowledge cannot stop this boiling pit of self loathing from overflowing, turing a simple reflection into an acid tipped dagger cutting me to the depths of my soul. Yes I have looked upon myself and wanted nothing more than to stop, to not just de-transition, but to erase every trace of these past years from my heart and memory.
For so much of my life I was able to submerge this other part of myself, to turn a blind eye, a deaf ear. Certainly I could do so once more… Or maybe, just maybe, this time would destroy me, who ever I am, leaving nothing but an empty unfeeling shell behind.
Yes, this has crossed my mind more in the past days… to commit a form of mental suicide, to allow myself to break so completely I could never be fixed again.
Then all of the questions, doubts and fears would become meaningless.
“Planned Parenthood helping transgender patients with sex changes by offering hormone treatment
Non-profit organisation is offering hormone treatments at 32 clinics States including California, Colorado, North Carolina and Vermont
In all cases, PP only offers hormone therapy but doesn’t assist in the surgical aspects of sex change Planned Parenthood health centers are ‘open to people of all gender identities and sexual orientations’, says the site “
“A medical school professor wants to provide better care for transgender patients.”
“Small survey reveals lack of knowledge about these patients”