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New clinical care guidelines produced for transgender and gender diverse people (TGD)

New guidelines in Australia have been produced for transgender and gender diverse people (TGD) to receive better health care.

The guidelines aim to help address a gap in education and understanding of how to provide appropriate care to transgender and gender diverse people.

Lead author Dr. Ada Cheung wrote that the rise and demand for gender affirming hormone therapy mandates a need for more formalized care of TGD people in Australia.

Dr. Cheung and her colleagues made seven main recommendations:

·         hormonal therapy is effective at aligning physical characteristics with gender identity and in addition to respectful care, may improve mental health symptoms;

·         masculinising hormone therapy options include transdermal or intramuscular testosterone at standard doses;

·         feminising hormone therapy options include transdermal or oral estradiol; additional anti-androgen therapy with cyproterone acetate or spironolactone is typically required;

·         treatment should be adjusted to clinical response. For biochemical monitoring, target estradiol and testosterone levels in the reference range of the affirmed gender;

·         monitoring is suggested for adverse effects of hormone therapy;

·         preferred names in use and pronouns should be used during consultations and reflected in medical records;

·         while being TGD is not a mental health disorder, individualised mental health support to monitor mood during medical transition is recommended.

Cheung and her colleagues wrote that while gender affirming hormone therapy is effective and relatively safe with appropriate monitoring, research is still needed to guide clinical care and understanding the long term effects of hormone therapies.

Dr. Cheung also said estimates suggest that 0.1 to 2% of the population are TGD yet medical education in Transgender Health is lacking. She said The aim is to provide a general practitioners, physicians and other medical professionals with specific Australian recommendations for the hormonal and related management of adult TGD individuals.

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