Materiały źródłowe

• #1 Gender dysphoria – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/diagnosis-treatment/drc-20475262

  A diagnosis of gender dysphoria includes distress due to gender identity differing from sex assigned at birth that lasts at least six months and involves two or more of the following: […] The purpose of treatment is to ease gender dysphoria. Specific goals for gender dysphoria treatment depend on the person. […] Treatment for gender dysphoria can include changes in gender expression, hormone therapy, surgery and supportive behavioral health therapy. […] Medical treatment of gender dysphoria might include: Gender-affirming hormone therapy to better align the body with gender identity. Gender-affirming surgery, such as procedures that make changes to the chest, genitals or facial features. […] A behavioral health evaluation also may be done by a healthcare professional with expertise in transgender health. The evaluation may assess: Gender health goals. Mental health concerns. Sexual health concerns. The impact of gender dysphoria at work, at school, at home and in social settings.

• #2

  https://111.wales.nhs.uk/genderdysphoria/

  Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. […] Many people with gender dysphoria have a strong, lasting desire to live a life that „matches” or expresses their gender identity. They do this by changing the way they look and behave. […] Some people with gender dysphoria, but not all, may want to use hormones and sometimes surgery to express their gender identity. […] After a detailed assessment to confirm the diagnosis of gender dysphoria and what it means for you, the GDC team will work with you on an agreed treatment plan. […] Treatments provided by the GDC are intended to provide lasting relief from gender dysphoria. This can mean different things to different people.

• #3

  https://slam.nhs.uk/gender-dysphoria

  Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. […] This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life. […] Many people with gender dysphoria have a strong, lasting desire to live a life that „matches” or expresses their gender identity. They do this by changing the way they look and behave. […] Some people with gender dysphoria, but not all, may want to use hormones and sometimes surgery to express their gender identity. […] Gender dysphoria is not a mental illness, but some people may develop mental health problems because of gender dysphoria. […] After a detailed assessment to confirm the diagnosis of gender dysphoria and what it means for you, the GDC team will work with you on an agreed treatment plan.

• #4 Gender dysphoria – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/diagnosis-treatment/drc-20475262

  A diagnosis of gender dysphoria includes distress due to gender identity differing from sex assigned at birth that lasts at least six months and involves two or more of the following: […] The purpose of treatment is to ease gender dysphoria. Specific goals for gender dysphoria treatment depend on the person. […] Treatment for gender dysphoria can include changes in gender expression, hormone therapy, surgery and supportive behavioral health therapy. […] Medical treatment of gender dysphoria might include: Gender-affirming hormone therapy to better align the body with gender identity. Gender-affirming surgery, such as procedures that make changes to the chest, genitals or facial features. […] A behavioral health evaluation also may be done by a healthcare professional with expertise in transgender health. The evaluation may assess: Gender health goals. Mental health concerns. Sexual health concerns. The impact of gender dysphoria at work, at school, at home and in social settings.

• #5 Gender dysphoria | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/gender-dysphoria

  The goal of behavioral health therapy is to improve mental well-being and quality of life. It isn’t intended to change gender identity. Instead, this therapy can help people explore gender concerns and find ways to ease gender dysphoria. […] Other ways to ease gender dysphoria might include use of: Affirming name and pronouns. Voice and communication therapy to develop vocal characteristics that better align with gender identity. Hair removal or hair transplants. Genital tucking. Chest binding. Breast padding. Genital packing. Legal services to help with name and gender changes on legal documents. Services to assist with appearance, such as makeup or clothing. Social and community services to help deal with issues such as workplace, family or parenting concerns.

• #6 Gender Incongruence and Gender Dysphoria – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/gender-incongruence-and-gender-dysphoria/gender-incongruence-and-gender-dysphoria

  When treatment is required, it is aimed at relieving patients’ distress and helping them adapt to rather than trying to dissuade them from their identity. […] Using psychotherapy to try to „convert” a person’s established transgender identity (so-called reparative therapy or conversion therapy) is not only ineffective but can be harmful to patients, is considered unethical, and is illegal in some jurisdictions. […] When gender dysphoria is appropriately diagnosed and treated, the psychological distress may resolve with a combination of psychotherapy, gender-affirming hormone therapy, and gender-affirming surgeries. […] Studies have found that gender-affirming surgery is associated with improved mental health outcomes in people with gender dysphoria. […] It should be noted that gender-affirming surgeries are not limited to genital interventions but may also include facial changes, vocal cord surgery, breast augmentation, laryngeal shave, or other nongenital surgeries.

• #7 Gender Dysphoria and Its Non-Surgical and Surgical Treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9501960/

  Gender dysphoria is defined by severe or persistent distress associated with an incongruence between ones gender identity and biological sex. […] Treatment includes psychosocial therapy, pharmacotherapy for underlying depression and/or anxiety, hormonal therapy, non-genital and/or genital feminization or masculinization operations. […] Patients with gender dysphoria who receive treatment report happier lives. […] Treatment starts with hormone therapy. […] The treatment for gender dysphoria is often multi-disciplinary, combining the efforts of several behavioral health and medical professionals. […] The first non-operative option is psychosocial therapy and counseling. […] The second non-operative treatment option is medical management with hormone replacement therapy (HRT). […] Many patients with gender dysphoria require some form of surgery to fully achieve their desired body image and psychological gender identity.

• #8 Gender Dysphoria/Gender Incongruence Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence

  The 2017 guideline on endocrine treatment of gender dysphoric/gender incongruent persons: […] Emphasizes that a broader healthcare team is needed to provide mental health services and other treatments, such as gender-affirmation surgery. […] Diagnosing clinicians, mental health providers for adolescents, and mental health professionals for adults all should be knowledgeable about the diagnostic criteria for gender-affirming treatment, have sufficient training and experience in assessing related mental health conditions, and be willing to participate in the ongoing care throughout the endocrine transition. […] Gender-dysphoric/gender-incongruent persons should receive a safe and effective hormone regimen that will suppress the body’s sex hormone secretion, determined at birth and manifested at puberty, and maintain levels of sex steroids within the normal range for the person’s affirmed gender.

• #9 Gender dysphoria – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/diagnosis-treatment/drc-20475262

  The goal of behavioral health therapy is to improve mental well-being and quality of life. It isn’t intended to change gender identity. Instead, this therapy can help people explore gender concerns and find ways to ease gender dysphoria. […] Behavioral health therapy often can help people with gender dysphoria feel comfortable with the way they express gender identity. That may help improve daily life, including school, work and relationships. The treatment also can address other mental health concerns. […] Other ways to ease gender dysphoria might include use of: Affirming name and pronouns. Voice and communication therapy to develop vocal characteristics that better align with gender identity. […] Talk with your healthcare professional about whether these steps may be helpful for you.

• #10 Gender Affirming Therapy for Gender Dysphoria: A Rapid Qualitative Review – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564233/

  Participants expressed a preference for having primary care physicians rather than specialists provide hormone replacement therapy and surgery referrals. Primary care physicians were viewed as preferable because of their greater accessibility and because they were viewed as more able to provide holistic care that included medical, psychological and social needs. […] Participants sought supportive primary care physicians who could provide positive spaces. However, participants frequently reported experiencing discriminatory encounters in the health care setting. Discriminatory practices such as misgendering, deadnaming or being outed in the health care space often led to the avoidance or delay of health care, including for gender affirming care. […] Clinicians reported that they had received virtually no formal education regarding transgender health. They learned on the job through courses, through resources and through their patients. Clinicians emphasized the importance of fostering a positive patient-provider relationship built on trust.

• #11 Gender Dysphoria and Its Non-Surgical and Surgical Treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9501960/

  Gender dysphoria is defined by severe or persistent distress associated with an incongruence between ones gender identity and biological sex. […] Treatment includes psychosocial therapy, pharmacotherapy for underlying depression and/or anxiety, hormonal therapy, non-genital and/or genital feminization or masculinization operations. […] Patients with gender dysphoria who receive treatment report happier lives. […] Treatment starts with hormone therapy. […] The treatment for gender dysphoria is often multi-disciplinary, combining the efforts of several behavioral health and medical professionals. […] The first non-operative option is psychosocial therapy and counseling. […] The second non-operative treatment option is medical management with hormone replacement therapy (HRT). […] Many patients with gender dysphoria require some form of surgery to fully achieve their desired body image and psychological gender identity.

• #12 Gender Dysphoria | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/gender-dysphoria

  Gender-affirming psychotherapy provides a safe environment in which children, adolescents, and adults can safely explore their gender identity and find a comfortable gender expression. The goal of gender-affirming therapy is to facilitate identity development across the lifespan, assist individuals and their families in coping with any social stigma they may encounter, and promote resilience. […] A family based approach is also highly recommended for children and adolescents with gender dysphoria. Family approaches emphasize the role of parents and other family members in treatment. This can include family sessions or parent groups that empower family members with tools to help in improving their relationship and communication within the family and to support the gender journey of their child.

• #13 Gender Dysphoria: Therapy and Coping Strategies – Resilience Therapy DBT & Eating Disorders

  https://resiliencetherapy.com/blog/how-therapy-can-help-with-gender-dysphoria/

  Another vital aspect of therapy is learning effective coping mechanisms. Your therapist can teach you techniques to manage anxiety, depression, and other mental health challenges that often accompany gender dysphoria. […] If you decide to pursue social or medical transition, therapy can be an invaluable resource. Your therapist can help you plan and prepare for coming out to friends, family, and colleagues. […] Transitioning is a highly personal process, and theres no one-size-fits-all approach. Your therapist can assist you in creating a personalized transition plan that aligns with your goals and comfort level. […] Cognitive-behavioral therapy is a cornerstone in treating gender dysphoria. This approach helps you identify and challenge negative thought patterns related to your gender identity.

• #14 What Is the Best Therapy for Gender Dysphoria? – Collaborative Change Counseling and Wellness

  https://collaborativechangecounseling.com/what-is-the-best-therapy-for-gender-dysphoria/

  This type of treatment is an excellent first step because it can help you make informed decisions about any subsequent medical treatment options. […] In the case of gender dysphoria-related mental conditions, there is no medication that can address gender dysphoria. However, a doctor may prescribe medications to alleviate the symptoms of anxiety and depression that may accompany, or result from, gender dysphoria. […] Some people may wish to use hormone therapy to align their physical bodies with their gender identity. […] These physical changes can contribute to the patient feeling more comfortable in their body. […] Gender dysphoria surgery is also called gender affirmation or sex reassignment surgery. […] It’s important to note that gender affirmation surgery is not for everyone struggling with gender dysphoria. […] The choice to have or forego surgery does not mean the experience of gender dysphoria is any more or less genuine or authentic. […] Treatment helps relieve negative emotions about gender. Talking to a medical professional is vital if you feel conflicted, confused or distressed about your gender.

• #15 Gender Dysphoria: Definition, Symptoms, Traits, Causes, Treatment

  https://www.verywellmind.com/gender-dysphoria-5085081

  Masculinizing and feminizing hormones can sometimes help lessen or resolve feelings of gender dysphoria. Such hormones can have side effects, including changes in libido and the potential for manic, hypomanic, or psychotic symptoms in people with an underlying psychiatric condition. […] However, people who cannot take any of these steps may begin to experience increased psychological distress, including feelings of anxiety and depression. In such cases, psychotherapy may help people feel more comfortable expressing their internal sense of gender and improve mental well-being. […] Some individuals may wish to have counseling to help them feel more comfortable with their feelings, affirm their identity, and help them cope or reduce any feelings of distress. Relationship or family counseling can help partners, parents, and other family members better understand what their loved one is experiencing. This can help the individual gain social and peer support, providing a more affirming environment.

• #16 Gender dysphoria | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/gender-dysphoria

  The goal of behavioral health therapy is to improve mental well-being and quality of life. It isn’t intended to change gender identity. Instead, this therapy can help people explore gender concerns and find ways to ease gender dysphoria. […] Other ways to ease gender dysphoria might include use of: Affirming name and pronouns. Voice and communication therapy to develop vocal characteristics that better align with gender identity. Hair removal or hair transplants. Genital tucking. Chest binding. Breast padding. Genital packing. Legal services to help with name and gender changes on legal documents. Services to assist with appearance, such as makeup or clothing. Social and community services to help deal with issues such as workplace, family or parenting concerns.

• #17 Psychiatry.org – Gender-Affirming Therapy

  https://www.psychiatry.org/psychiatrists/diversity/education/transgender-and-gender-nonconforming-patients/gender-affirming-therapy

  Gender Affirming Therapy is a therapeutic stance that focuses on affirming a patients gender identity and does not try to repair it. […] This introductory guide offers an array of topics that will be essential in understanding how to work with TGNC patients. It provides basic information to raise awareness of the needs of TGNC patients and how to incorporate gender-affirming care in psychiatric practices. […] Although TGNC patients have been treated psychiatrically, medically, and surgically for the past 100 years, standards of care regarding this patient population are still in infancy. Thus, research is still needed to develop more effective treatment.

• #18 Gender Identity & Dysphoria Treatment | Charlie Health

  https://www.charliehealth.com/areas-of-care/gender-identity-dysphoria

  Gender dysphoria is typically diagnosed through a clinical evaluation by a mental health or healthcare professional. This involves assessing a person’s experiences and feelings related to their gender identity, including any distress or discomfort associated with their gender assigned at birth. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the complete diagnostic criteria. Diagnosis of gender dysphoria is not meant to pathologize being transgender but to make it easier for people to get the healthcare and support they need, like hormone therapy or gender-affirming surgery. […] At Charlie Health, we work with our clients experiencing gender dysphoria using multimodal approaches that include recognition, psychological support, and affirmation. […] Cognitive behavioral therapy (CBT) can help those with gender dysphoria address negative thoughts and beliefs about their gender, reduce anxiety and depression, and learn healthy coping strategies. In the treatment of gender dysphoria, CBT can help people change self-critical thoughts, address gender-related fears, and build resilience against societal and self-imposed gender pressures. CBT can improve mental well-being, help people develop a more positive relationship with gender identity, and make transitioning, if desired, easier.

• #19 Gender Dysphoria – A Quick Guide – Child Mind Institute

  https://childmind.org/guide/gender-dysphoria-quick-guide/

  Treatment for gender dysphoria focuses on helping kids deal with their challenging feelings about their gender identity. It does not try to change their gender identity or convince them that they should be the gender they were assigned at birth. […] Dialectical behavior therapy (DBT) is commonly used to treat gender dysphoria. DBT helps the child understand that their emotions are normal and helps them learn skills for dealing with them and feeling better about themselves. […] Additionally, treatment for gender dysphoria helps kids and their families figure out how the child can express their gender in a healthy way that makes them feel good. Sometimes, this can involve hormone treatment or affirmative medical care, which can make the child’s body match their internal gender identity. A therapist can help families decide whether these options make sense for the child’s specific situation.

• #20 Gender Identity & Dysphoria Treatment | Charlie Health

  https://www.charliehealth.com/areas-of-care/gender-identity-dysphoria

  Gender-affirming therapy is designed to support people with gender dysphoria in their gender identity exploration and transition. It supports a person’s true gender identity, helps them develop coping skills, and enables them to make informed choices about medical treatments like hormone therapy or gender-affirming surgeries. This therapy also offers a safe place to discuss challenges and discrimination faced by transgender and gender-diverse people, improving mental well-being and their connection with their gender identity. […] When someone has gender dysphoria, family therapy creates a safe space for family members to provide emotional support and learn about gender diversity. By involving the family, therapy can reduce stress and isolation for transgender and gender-diverse people, making their home environment more supportive. It also helps families navigate the challenges of the person’s gender transition and promotes healthier, more inclusive relationships, which can significantly improve the person’s well-being. […] These symptoms can cause emotional distress, anxiety, and depression and affect a person’s ability to function in the world, highlighting the importance of providing gender-affirming care and support to those experiencing gender dysphoria.

• #21

• #22 Gender dysphoria | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/gender-dysphoria

  The goal of behavioral health therapy is to improve mental well-being and quality of life. It isn’t intended to change gender identity. Instead, this therapy can help people explore gender concerns and find ways to ease gender dysphoria. […] Other ways to ease gender dysphoria might include use of: Affirming name and pronouns. Voice and communication therapy to develop vocal characteristics that better align with gender identity. Hair removal or hair transplants. Genital tucking. Chest binding. Breast padding. Genital packing. Legal services to help with name and gender changes on legal documents. Services to assist with appearance, such as makeup or clothing. Social and community services to help deal with issues such as workplace, family or parenting concerns.

• #23 Gender Dysphoria | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.gender-dysphoria.abs2270

  Usually, gender dysphoria is treated by helping someone affirm their gender identity through finding ways to express it. […] The types of things that help someone express their gender can vary from person to person. They can also be different for children and young people than for adults. […] Non-medical options for expressing gender identity may include: Clothing, hairstyles, or makeup. Voice therapy or coaching. Hair removal. Breast binding or padding. Penis tucking or packing. Name and gender marker corrections on official documents. Counseling. […] Medical options may include: Gender-affirming hormones. Puberty-blocking medicines. Gender-affirming surgeries.

• #24 Gender dysphoria – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/diagnosis-treatment/drc-20475262

  The goal of behavioral health therapy is to improve mental well-being and quality of life. It isn’t intended to change gender identity. Instead, this therapy can help people explore gender concerns and find ways to ease gender dysphoria. […] Behavioral health therapy often can help people with gender dysphoria feel comfortable with the way they express gender identity. That may help improve daily life, including school, work and relationships. The treatment also can address other mental health concerns. […] Other ways to ease gender dysphoria might include use of: Affirming name and pronouns. Voice and communication therapy to develop vocal characteristics that better align with gender identity. […] Talk with your healthcare professional about whether these steps may be helpful for you.

• #25 Mayo Clinic Health Library – Gender dysphoria | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20458679

  Behavioral health therapy often can help people with gender dysphoria feel comfortable with the way they express gender identity. That may help improve daily life, including school, work and relationships. The treatment also can address other mental health concerns. […] Other ways to ease gender dysphoria might include use of: Affirming name and pronouns. Voice and communication therapy to develop vocal characteristics that better align with gender identity. Hair removal or hair transplants. Genital tucking. Chest binding. Breast padding. Genital packing. Legal services to help with name and gender changes on legal documents. Services to assist with appearance, such as makeup or clothing. Social and community services to help deal with issues such as workplace, family or parenting concerns. […] Talk with your healthcare professional about whether these steps may be helpful for you.

• #26 Gender Dysphoria | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.gender-dysphoria.abs2270

  Usually, gender dysphoria is treated by helping someone affirm their gender identity through finding ways to express it. […] The types of things that help someone express their gender can vary from person to person. They can also be different for children and young people than for adults. […] Non-medical options for expressing gender identity may include: Clothing, hairstyles, or makeup. Voice therapy or coaching. Hair removal. Breast binding or padding. Penis tucking or packing. Name and gender marker corrections on official documents. Counseling. […] Medical options may include: Gender-affirming hormones. Puberty-blocking medicines. Gender-affirming surgeries.

• #27

• #28

  https://www.nhs.uk/conditions/gender-dysphoria/treatment/

  It’s important to remember that hormone therapy is only one of the treatments for gender dysphoria. Others include voice therapy and psychological support. The decision to have hormone therapy will be taken after a discussion between you and your clinic team. […] There is some uncertainty about the risks of long-term cross-sex hormone treatment. The clinic will discuss these with you and the importance of regular monitoring blood tests with your GP. […] Some people may decide to have surgery to permanently alter body parts associated with their biological sex. […] Whether you’ve had hormone therapy alone or combined with surgery, the aim is that you no longer have gender dysphoria and feel at ease with your identity.

• #29

  https://www.nhs.uk/conditions/gender-dysphoria/treatment/

  Treatment for gender dysphoria aims to help people live the way they want to, in their preferred gender identity or as non-binary. […] Most treatments offered at this stage are psychological rather than medical. This is because in many cases gender variant behaviour or feelings disappear as children reach puberty. […] Some young people with lasting signs of gender dysphoria who meet strict criteria may be referred to a hormone specialist (consultant endocrinologist). This is in addition to psychological support. […] From around the age of 16, young people with a diagnosis of gender incongruence or gender dysphoria who meet various clinical criteria may be given gender-affirming hormones alongside psychosocial and psychological support. […] The aim of hormone therapy is to make you more comfortable with yourself, both in terms of physical appearance and how you feel. The hormones usually need to be taken for the rest of your life, even if you have gender surgery.

• #30 Gender Dysphoria | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/gender-dysphoria

  Gender affirming medical interventions are available that may help alleviate gender dysphoria. The decision to pursue medical interventions is highly personal, and is best evaluated in the context of overall identity development and wellbeing. Consultation with an interdisciplinary team of healthcare professionals specializing in transgender care may be helpful in making a fully informed decision that meets the individuals needs. […] Puberty suppression can be used to delay puberty in children with gender dysphoria. This intervention allows youth more time to explore their gender identity and consider potential future interventions to physically masculinize or feminize. […] Hormone therapy is often used to assist in the development of physical sex characteristics that are congruent with a persons gender identity.

• #31 Puberty blockers for transgender and gender-diverse youth

  https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/in-depth/pubertal-blockers/art-20459075

  Puberty blockers can be used to delay the changes of puberty in transgender and gender-diverse youth who have started puberty. […] For transgender and gender-diverse youth who have gender dysphoria, delaying puberty might: Improve mental well-being. Ease depression and anxiety. Improve social interactions with others. Lower the need for future surgeries. Ease thoughts or actions of self-harm. […] Taking puberty blockers alone, however, without other medical or behavioral treatment, might not be enough to ease gender dysphoria. […] Assessment and counseling by a behavioral health care professional can help youth and their families as they move through the decision-making process about puberty blockers. Behavioral health care also is an important source of support while taking puberty blockers.

• #32 Puberty blockers for transgender and gender-diverse youth

  https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/in-depth/pubertal-blockers/art-20459075

  Puberty blockers can be used to delay the changes of puberty in transgender and gender-diverse youth who have started puberty. […] For transgender and gender-diverse youth who have gender dysphoria, delaying puberty might: Improve mental well-being. Ease depression and anxiety. Improve social interactions with others. Lower the need for future surgeries. Ease thoughts or actions of self-harm. […] Taking puberty blockers alone, however, without other medical or behavioral treatment, might not be enough to ease gender dysphoria. […] Assessment and counseling by a behavioral health care professional can help youth and their families as they move through the decision-making process about puberty blockers. Behavioral health care also is an important source of support while taking puberty blockers.

• #33 Gender Dysphoria | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/gender-dysphoria

  Gender affirming medical interventions are available that may help alleviate gender dysphoria. The decision to pursue medical interventions is highly personal, and is best evaluated in the context of overall identity development and wellbeing. Consultation with an interdisciplinary team of healthcare professionals specializing in transgender care may be helpful in making a fully informed decision that meets the individuals needs. […] Puberty suppression can be used to delay puberty in children with gender dysphoria. This intervention allows youth more time to explore their gender identity and consider potential future interventions to physically masculinize or feminize. […] Hormone therapy is often used to assist in the development of physical sex characteristics that are congruent with a persons gender identity.

• #34 Gender Dysphoria Treatment & Management: Approach Considerations, Psychological and Speech Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/2200534-treatment

  In male-to-female individuals, original sex characteristics can be suppressed with luteinizing hormone-releasing hormone (LHRH) agonists, progestational compounds (eg, medroxyprogesterone), spironolactone, flutamide, and cyproterone acetate. Breasts, increased body fat, and a more feminine body shape can be promoted with ethinyl estradiol (0.1-0.5 mg/day) and conjugated estrogen (7.5-10 mg/day). In female-to-male individuals, facial and body hair growth may be promoted with testosterone cypionate (200 mg IM every 2 weeks). […] Controversy exists regarding whether adolescents should be allowed to pursue SRS. Many countries deny SRS to adolescents; however, early treatment may be beneficial in adolescents whose secondary sex characteristics (eg, facial hair, lowered voice, and breast development) have not yet developed fully. In such cases, parental involvement and approval are essential.

• #35 Gender Dysphoria Treatment & Management: Approach Considerations, Psychological and Speech Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/2200534-treatment

  In male-to-female individuals, original sex characteristics can be suppressed with luteinizing hormone-releasing hormone (LHRH) agonists, progestational compounds (eg, medroxyprogesterone), spironolactone, flutamide, and cyproterone acetate. Breasts, increased body fat, and a more feminine body shape can be promoted with ethinyl estradiol (0.1-0.5 mg/day) and conjugated estrogen (7.5-10 mg/day). In female-to-male individuals, facial and body hair growth may be promoted with testosterone cypionate (200 mg IM every 2 weeks). […] Controversy exists regarding whether adolescents should be allowed to pursue SRS. Many countries deny SRS to adolescents; however, early treatment may be beneficial in adolescents whose secondary sex characteristics (eg, facial hair, lowered voice, and breast development) have not yet developed fully. In such cases, parental involvement and approval are essential.

• #36 An affirming approach to caring for transgender and gender-diverse youth | Canadian Paediatric Society

  https://cps.ca/en/documents/position/an-affirming-approach-to-caring-for-transgender-and-gender-diverse-youth

  Formal efforts to change a young person’s gender identity, sometimes referred to as conversion or reparative therapy, are harmful and unethical and should not be undertaken. […] Gender-affirming medical interventions may be an important component of comprehensive care for some TGD adolescents. […] Some TGD adolescents may only ever desire social transition, while others may pursue social transition initially and later become interested in medical options, while still others may articulate a clear goal of medical transition from early in adolescence. […] Gender-affirming hormone therapy (GAHT) can be an important care component. […] GAHT is considered a partially reversible intervention because hormone administration over time results in both reversible and irreversible changes. […] Prescription of GAHT should only be provided to adolescents with a confirmed diagnosis of gender dysphoria or gender incongruence who demonstrate the capacity to understand and appreciate both the benefits and risks of these medications, given their profound effects.

• #37 An affirming approach to caring for transgender and gender-diverse youth | Canadian Paediatric Society

  https://cps.ca/en/documents/position/an-affirming-approach-to-caring-for-transgender-and-gender-diverse-youth

  When GAHT is initiated appropriately for adolescents who desire this option, it has been associated with improved perceived well-being and mental health, decreased suicidality, and decreased body dissatisfaction. […] Gender-affirming surgeries are less commonly performed in the adolescent population, but TGD youth may identify surgery as one of their transition goals.

• #38

  https://www.nhs.uk/conditions/gender-dysphoria/treatment/

  Treatment for gender dysphoria aims to help people live the way they want to, in their preferred gender identity or as non-binary. […] Most treatments offered at this stage are psychological rather than medical. This is because in many cases gender variant behaviour or feelings disappear as children reach puberty. […] Some young people with lasting signs of gender dysphoria who meet strict criteria may be referred to a hormone specialist (consultant endocrinologist). This is in addition to psychological support. […] From around the age of 16, young people with a diagnosis of gender incongruence or gender dysphoria who meet various clinical criteria may be given gender-affirming hormones alongside psychosocial and psychological support. […] The aim of hormone therapy is to make you more comfortable with yourself, both in terms of physical appearance and how you feel. The hormones usually need to be taken for the rest of your life, even if you have gender surgery.

• #39

  https://www.nhs.uk/conditions/gender-dysphoria/treatment/

  It’s important to remember that hormone therapy is only one of the treatments for gender dysphoria. Others include voice therapy and psychological support. The decision to have hormone therapy will be taken after a discussion between you and your clinic team. […] There is some uncertainty about the risks of long-term cross-sex hormone treatment. The clinic will discuss these with you and the importance of regular monitoring blood tests with your GP. […] Some people may decide to have surgery to permanently alter body parts associated with their biological sex. […] Whether you’ve had hormone therapy alone or combined with surgery, the aim is that you no longer have gender dysphoria and feel at ease with your identity.

• #40 Gender Dysphoria and Its Non-Surgical and Surgical Treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9501960/

  Genital surgeries specifically are often the last recommended as part of the overall treatment of gender dysphoria. […] The WPATH recommends patients undergo some form of social transition utilizing psychotherapy and HRT prior to considering surgical treatment, but it is not a requirement for all procedures.

• #41 Gender Dysphoria | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/gender-dysphoria

  Gender-affirming surgeries such as chest surgery (breast reduction, removal, or augmentation), genital surgery, or other surgeries to masculinize or feminize ones body and appearance (e.g., facial feminization surgery) may be important to alleviate gender dysphoria. […] The Gender Identity Program is a specialized service that offers treatment geared for the needs of transgender, nonbinary, and gender nonconforming individuals and their families. We provide evaluation (including referral for medical interventions) and affirmative psychotherapy for gender dysphoria. We work as an interdisciplinary team to ensure access to medically necessary interventions and coordination of care across providers.

• #42

  https://111.wales.nhs.uk/genderdysphoria/

  It’s important to remember that hormone therapy is only one of the treatments for gender dysphoria. Others include voice therapy and psychological support. […] Some people may decide to have surgery to permanently alter body parts associated with their biological sex. […] Gender surgery for trans men includes: construction of a penis (phalloplasty or metoidioplasty), construction of a scrotum (scrotoplasty) and testicular implants. […] Gender surgery for trans women includes: removal of the testes (orchidectomy), removal of the penis (penectomy), construction of a vagina (vaginoplasty).

• #43 Gender Incongruence and Gender Dysphoria – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/gender-incongruence-and-gender-dysphoria/gender-incongruence-and-gender-dysphoria

  When treatment is required, it is aimed at relieving patients’ distress and helping them adapt to rather than trying to dissuade them from their identity. […] Using psychotherapy to try to „convert” a person’s established transgender identity (so-called reparative therapy or conversion therapy) is not only ineffective but can be harmful to patients, is considered unethical, and is illegal in some jurisdictions. […] When gender dysphoria is appropriately diagnosed and treated, the psychological distress may resolve with a combination of psychotherapy, gender-affirming hormone therapy, and gender-affirming surgeries. […] Studies have found that gender-affirming surgery is associated with improved mental health outcomes in people with gender dysphoria. […] It should be noted that gender-affirming surgeries are not limited to genital interventions but may also include facial changes, vocal cord surgery, breast augmentation, laryngeal shave, or other nongenital surgeries.

• #44 Gender Dysphoria: Definition, Symptoms, Traits, Causes, Treatment

  https://www.verywellmind.com/gender-dysphoria-5085081

  Hormone therapy and surgery are two ways to accomplish this. But again, treatment needs to be adapted to the needs and goals of the individual. Some people may want to achieve a full transition to the gender with which they identify. Others may wish only to minimize the secondary sex characteristics, such as facial hair or breasts, that do not align with their gender identity. […] It is important to remember that while surgical gender affirmation surgery is an option, not everyone with gender dysphoria makes that choice. Surgery is expensive and usually not covered by insurance, and not everyone wants to have complete gender reassignment. Hormone therapy may help some people, while others may choose to change their outward gender expression and dress to correspond with their internal sense of gender identity.

• #45 What Is the Best Therapy for Gender Dysphoria? – Collaborative Change Counseling and Wellness

  https://collaborativechangecounseling.com/what-is-the-best-therapy-for-gender-dysphoria/

  This type of treatment is an excellent first step because it can help you make informed decisions about any subsequent medical treatment options. […] In the case of gender dysphoria-related mental conditions, there is no medication that can address gender dysphoria. However, a doctor may prescribe medications to alleviate the symptoms of anxiety and depression that may accompany, or result from, gender dysphoria. […] Some people may wish to use hormone therapy to align their physical bodies with their gender identity. […] These physical changes can contribute to the patient feeling more comfortable in their body. […] Gender dysphoria surgery is also called gender affirmation or sex reassignment surgery. […] It’s important to note that gender affirmation surgery is not for everyone struggling with gender dysphoria. […] The choice to have or forego surgery does not mean the experience of gender dysphoria is any more or less genuine or authentic. […] Treatment helps relieve negative emotions about gender. Talking to a medical professional is vital if you feel conflicted, confused or distressed about your gender.

• #46 Gender Dysphoria/Gender Incongruence Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence

  We recommend against puberty blocking and gender-affirming hormone treatment in prepubertal children with GD/gender incongruence. […] We suggest that adolescents who meet diagnostic criteria for GD/gender incongruence, fulfill criteria for treatment, and are requesting treatment should initially undergo treatment to suppress pubertal development. […] We recommend that clinicians confirm the diagnostic criteria of GD/gender incongruence and the criteria for the endocrine phase of gender transition before beginning treatment. […] We suggest that clinicians measure hormone levels during treatment to ensure that endogenous sex steroids are suppressed and administered sex steroids are maintained in the normal physiologic range for the affirmed gender. […] We recommend that a patient pursue genital gender-affirming surgery only after the MHP and the clinician responsible for endocrine transition therapy both agree that surgery is medically necessary and would benefit the patient’s overall health and/or well-being.

• #47 An affirming approach to caring for transgender and gender-diverse youth | Canadian Paediatric Society

  https://cps.ca/en/documents/position/an-affirming-approach-to-caring-for-transgender-and-gender-diverse-youth

  Increasing numbers of youth identify as transgender or gender-diverse (TGD). […] This statement is intended as a resource to guide paediatricians and PCPs in implementing an affirming approach to routine health care provision for all youth. […] Furthermore, it presents information to assist providers in responding to requests for counselling from TGD youth and their families around potential options for medical transition, and in making referrals to specialized services, if desired and relevant. […] Some health care providers (HCPs) may wish to develop the knowledge and skills required to initiate adolescents on hormone-blocking agents and gender-affirming hormones. […] This document is not intended to be a clinical practice guideline, but will provide foundational information regarding these potential components of gender-affirming care, recognizing that the needs and goals of individual adolescents may or may not include such interventions.

• #48 Gender Dysphoria – A Quick Guide – Child Mind Institute

  https://childmind.org/guide/gender-dysphoria-quick-guide/

  Treatment for gender dysphoria focuses on helping kids deal with their challenging feelings about their gender identity. It does not try to change their gender identity or convince them that they should be the gender they were assigned at birth. […] Dialectical behavior therapy (DBT) is commonly used to treat gender dysphoria. DBT helps the child understand that their emotions are normal and helps them learn skills for dealing with them and feeling better about themselves. […] Additionally, treatment for gender dysphoria helps kids and their families figure out how the child can express their gender in a healthy way that makes them feel good. Sometimes, this can involve hormone treatment or affirmative medical care, which can make the child’s body match their internal gender identity. A therapist can help families decide whether these options make sense for the child’s specific situation.

• #49 What is the Best Approach to Therapy for Gender Dysphoria? A Paoli, PA Therapist Shares Info | Arrive Therapy Near Philadelphia, PA for LGBTQ+ Folx

  https://arrivetherapy.com/media/what-is-the-best-approach-to-therapy-for-gender-dysphoria

  Psychological treatment for gender dysphoria should offer a combination of psychosocial support, and, when necessary, medical and legal assistance. […] Affirmative Therapy: At its core, affirmative therapy respects and validates a person’s gender identity. […] Psychoeducation: Educating people and their families about gender dysphoria, gender identity, and the spectrum of gender experiences is crucial. […] Talk Therapy: Therapeutic conversations can support a person in accepting their gender dysphoria, discussing body image issues, and navigating the process of coming out. […] Medical and Legal Support: For those who choose to transition, whether socially, medically, or legally, therapists can provide guidance and referrals to appropriate services. […] Coping Strategies: Developing coping mechanisms to manage the stress and emotional turmoil associated with gender dysphoria is essential.

• #50 Gender dysphoria | Healthify

  https://healthify.nz/health-a-z/g/gender-dysphoria

  Where these feelings continue into or emerge during puberty, particularly if associated with distress, it is important to see a health professional. Puberty blockers are a medication that can be used to halt the physical changes of an unwanted puberty. […] For children who assert they have a mismatch between their sex and gender, including those who may identify as transgender, no medical intervention is needed pre-puberty. […] However, you may want to talk to a paediatrician, mental health professional or parent support group to work out how to best support your child or family member. This is particularly important if there is associated distress related to gender identity.

• #51

  https://www.nhs.uk/conditions/gender-dysphoria/treatment/

  Treatment for gender dysphoria aims to help people live the way they want to, in their preferred gender identity or as non-binary. […] Most treatments offered at this stage are psychological rather than medical. This is because in many cases gender variant behaviour or feelings disappear as children reach puberty. […] Some young people with lasting signs of gender dysphoria who meet strict criteria may be referred to a hormone specialist (consultant endocrinologist). This is in addition to psychological support. […] From around the age of 16, young people with a diagnosis of gender incongruence or gender dysphoria who meet various clinical criteria may be given gender-affirming hormones alongside psychosocial and psychological support. […] The aim of hormone therapy is to make you more comfortable with yourself, both in terms of physical appearance and how you feel. The hormones usually need to be taken for the rest of your life, even if you have gender surgery.

• #52 Gender Affirmation Surgery and Hormone Therapy

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/gender-affirmation-surgery-and-hormone-therapy/

  Prepubertal children do not require medical or surgical treatment, but do require mental health services as listed above. […] Gender affirmation surgery is rarely appropriate for patients under the age of 18. Requests for mastectomy for female to male transgender individuals age 17 or younger may be considered only in exceptional circumstances on an individual consideration basis. […] Gender Affirmation Surgery and hormone therapy are non-covered benefits when the member does not have benefits for the services requested contained in their health benefit plan. […] Gender affirmation surgery and hormone therapy candidate criteria and care standards are based, in part, on the World Professional Association for Transgender Health (WPATH) and Endocrine Society Guidelines for Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons.

• #53 Gender Dysphoria/Gender Incongruence Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence

  Hormone treatment is not recommended for pre-pubertal gender-dysphoric/gender-incongruent persons; […] For the care of youths during puberty and older adolescents, an expert multi-disciplinary team comprised of medical professionals and mental health professionals should manage treatment; […] For adult gender-dysphoric/gender-incongruent persons, the treating clinicians (collectively) should have expertise in transgender-specific diagnostic criteria, mental health, primary care, hormone treatment, and surgery, as needed by the patient; […] All individuals seeking gender-affirming medical treatment should receive information and counsel on options for fertility preservation prior to initiating puberty suppression in adolescents and prior to treating with hormonal therapy in both adolescents and adults.

• #54 Gender Affirmation Surgery and Hormone Therapy

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/gender-affirmation-surgery-and-hormone-therapy/

  Gender affirmation surgery and hormone therapy may be considered medically necessary when the criteria below are met. […] When gender affirmation surgery and hormone therapy are covered: Gender affirmation surgery and hormone therapy may be considered medically necessary when all the following candidate criteria are met and supporting provider documentation is provided: The candidate is at least 18 years of age; and Has been diagnosed with gender dysphoria, including meeting all of the following indications: A strong conviction to live as some alternative gender different from ones assigned gender. […] The candidate has completed a minimum of 12 months of successful continuous full time real-life experience in their affirmed gender, with no returning to their gender assigned at birth. […] The letters must attest to the psychological aspects of the candidates gender dysphoria.

• #55

  https://app.leg.wa.gov/wac/default.aspx?cite=182-531-1675

  Washington apple health Gender affirming interventions for gender dysphoria. (1) Overview of treatment program. (a) Medicaid agency coverage. The medicaid agency covers the services listed in (b) of this subsection to treat gender dysphoria (also referred to as gender incongruence) under WAC 182-501-0050 and 182-531-0100. […] (b) Medical services covered. Medical services covered by the agency include, but are not limited to: (i) Presurgical and postsurgical hormone therapy; (ii) Puberty suppression therapy; (iii) Behavioral health services; (iv) Gender affirming hair removal services; and (v) Surgical and ancillary services including, but not limited to: (A) Anesthesia; (B) Labs; (C) Pathology; (D) Radiology; (E) Hospitalization; (F) Physician services; and (G) Hospitalizations and physician services required to treat postoperative complications of procedures performed under this section.

• #56

  https://app.leg.wa.gov/wac/default.aspx?cite=182-531-1675

  (c) Diagnosis of gender dysphoria/gender incongruence. A diagnosis of gender dysphoria/gender incongruence is required to obtain services under this program and must be made by a provider who meets the qualifications outlined in chapter 182-502 WAC. […] (e) Provider requirements. Providers should be knowledgeable of gender-nonconforming identities and expressions, and the assessment and treatment of gender dysphoria/gender incongruence, including experience utilizing standards of care that include the World Professional Association for Transgender Health (WPATH) Standards of Care. […] (g) Transportation services. The agency covers transportation services under the provisions of chapter 182-546 WAC. […] (2) Prior authorization. (a) Prior authorization requirements for surgical services. As a condition of payment, the agency requires prior authorization for all surgical services to treat gender dysphoria/gender incongruence, except as provided in subsection (3) of this section.

• #57 An affirming approach to caring for transgender and gender-diverse youth | Canadian Paediatric Society

  https://cps.ca/en/documents/position/an-affirming-approach-to-caring-for-transgender-and-gender-diverse-youth

  Formal efforts to change a young person’s gender identity, sometimes referred to as conversion or reparative therapy, are harmful and unethical and should not be undertaken. […] Gender-affirming medical interventions may be an important component of comprehensive care for some TGD adolescents. […] Some TGD adolescents may only ever desire social transition, while others may pursue social transition initially and later become interested in medical options, while still others may articulate a clear goal of medical transition from early in adolescence. […] Gender-affirming hormone therapy (GAHT) can be an important care component. […] GAHT is considered a partially reversible intervention because hormone administration over time results in both reversible and irreversible changes. […] Prescription of GAHT should only be provided to adolescents with a confirmed diagnosis of gender dysphoria or gender incongruence who demonstrate the capacity to understand and appreciate both the benefits and risks of these medications, given their profound effects.

• #58 Gender Affirmation Surgery and Hormone Therapy

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/gender-affirmation-surgery-and-hormone-therapy/

  Gender affirmation surgery and hormone therapy may be considered medically necessary when the criteria below are met. […] When gender affirmation surgery and hormone therapy are covered: Gender affirmation surgery and hormone therapy may be considered medically necessary when all the following candidate criteria are met and supporting provider documentation is provided: The candidate is at least 18 years of age; and Has been diagnosed with gender dysphoria, including meeting all of the following indications: A strong conviction to live as some alternative gender different from ones assigned gender. […] The candidate has completed a minimum of 12 months of successful continuous full time real-life experience in their affirmed gender, with no returning to their gender assigned at birth. […] The letters must attest to the psychological aspects of the candidates gender dysphoria.

• #59

  https://www.oregon.gov/oha/hsd/ohp/pages/gender-affirming-care.aspx

  Adolescents may also need to: Have mental health and medical professionals fully assess them. Have their parent(s) or guardian(s) take part in the assessment, unless this is harmful or not possible. Have entered stage 2 of puberty (when physical changes start). For surgery: Have completed at least 12 months of hormone therapy.

• #60

  https://app.leg.wa.gov/wac/default.aspx?cite=182-531-1675

  (b) Required documentation. The provider must include the following documentation with the prior authorization request: (i) Behavioral health assessment. Documentation of a behavioral health assessment performed within 18 months preceding surgery by a qualified behavioral health professional as defined in WAC 182-531-1400. […] (c) Informed consent. The surgeon must provide documentation showing that they informed the client of: (i) The nature of the proposed care, treatment, services, medications, and procedures; (ii) Potential benefits, risks, or side effects, including potential problems that might occur during recuperation; (iii) The likelihood of achieving the client’s treatment goals; (iv) Reasonable alternatives; (v) Relevant risks, benefits, and side effects related to alternatives, including the possible results of not receiving care, treatment, and services; (vi) Any limitations on the confidentiality of information learned from or about the patient; (vii) The effect of gender-affirming treatment on reproduction; and (viii) Reproductive options before having gender-affirming surgeries that have the potential to create iatrogenic infertility.

• #61 Gender dysphoria Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/gender-dysphoria

  Not all transgender people need all forms of treatment. They can select one or more of the treatments listed above. […] Societal and family pressures and lack of acceptance can cause anxiety and depression and other mental health issues. This is why it’s important that you receive counseling and support throughout and even after your transition. It is also important to have emotional support from other people, such as from a support group or from close friends and family. […] Recognizing and treating gender dysphoria early can reduce the chance of depression, emotional distress, and suicide. Being in a supportive environment, being free to express your gender identity in a way that makes you comfortable, and understanding your options for treatment can help relieve anxiety and depression.

• #62 Navigating Gender Dysphoria: Comprehensive Therapy and Support Strategies – Therapy Group of DC

  https://therapygroupdc.com/therapist-dc-blog/navigating-gender-dysphoria-comprehensive-therapy-and-support-strategies/

  Seeking support from mental health professionals specializing in gender psychology is crucial for addressing these challenges. […] Gender-affirmative therapy provides a supportive environment for you to explore your gender identity with some focus and to address the signs and symptoms of gender dysphoria. […] Supportive psychotherapy offers a comprehensive approach that goes beyond gender identity exploration, providing a safe and validating space to address a range of emotional and psychological challenges. […] Involving your family in therapeutic support can significantly enhance your journey through gender dysphoria. […] Cognitive Behavioral Therapy (CBT) techniques can help you manage the psychological challenges associated with gender dysphoria. […] Medical treatments for gender dysphoria may include hormone therapy to align physical characteristics with gender identity, and gender-affirming surgeries like chest reconstruction or genital procedures.

• #63 Transgender Issues and Gender Dysphoria treatment in Orange county CA

  https://harbormentalhealth.com/conditions-treated/transgender-issues-and-gender-dysphoria/

  Transgender individuals face significant health disadvantages called Transgender Issues and Gender Dysphoria. […] A majority of transgender people experience mental health problems; however, transgender identity itself is not a psychological disorder but a normal variation in gender identity. Gender dysphoria, on the other hand, is considered a mental health condition. This condition and its medical and nonmedical treatments are described in the rest of this article. […] Interventions for gender dysphoria include medical and nonmedical options, as described below. […] Psychological treatments for gender dysphoria often emphasize exploration and support. Specifically, therapists assist patients in self-exploration of their gender identity, self-acceptance, building social support, understanding their sexuality, and coping more effectively with daily stressors.

• #64 Gender Affirming Therapy for Gender Dysphoria: A Rapid Qualitative Review – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564233/

  Transgender youth and adults faced numerous obstacles in having their health care needs met. Therefore, their journey required self-advocacy. There is the process of navigating the health care system to find a clinician who is knowledgeable and willing to provide care. […] Aside from the technical aspect of gender affirming care, participants also sought a supportive physician who could provide a positive space for transgender identities. This could be a challenge, because transgender individuals often had to contend with the stigma or discrimination within the context of the health care encounter, such as being outed or misnamed. […] Primary care clinicians in both the Canadian and American context reported that they had received virtually no formal education regarding transgender health. They learnt on the job through courses, through resources and through their patients. For the treatment of transgender patients, clinicians emphasized the importance of fostering a positive patient-provider relationship built on trust.

• #65 Can Gender Dysphoria Go Away with Time or Treatment?

  https://www.healthline.com/health/transgender/can-gender-dysphoria-go-away

  Gender dysphoria isn’t a phase that comes and goes at will. It usually stays with a person throughout their life, though it can ebb and flow in degree and severity. […] Treatments like talk therapy and hormone replacement therapy (HRT), for example, can help change your perspective and perception of your body and gender. […] If you are interested in medically transitioning to address your gender dysphoria, check out some of our other work on gender-affirming care. […] Gender dysphoria can be hard to work through but it’s not impossible. In addition to the tips mentioned here, it can be extremely valuable to find a therapist to help affirm your transition and help you care for your mental health along the way. […] Transitioning can help immensely with living a fulfilling and happy life. Whether that includes a new hairstyle, using HRT, getting gender-affirming surgical procedures, or other measures is entirely up to you. […] No matter what you decide, having supportive people around is essential. Sharing your feelings with trusted loved ones and building community with others can go a long way in alleviating dysphoria.

• #66

• #67 Gender dysphoria

  https://www.racgp.org.au/afp/2015/november/gender-dysphoria

  Gender dysphoria is the distress or discomfort that may occur when a persons biological sex and gender identity do not align. […] The aim of this article is to familiarise general practitioners (GPs) with the principles of transgender care so they may provide a safe and supportive environment for patients presenting with concerns. […] Management should be individualised and may involve a combination of social work, education, counselling, hormone therapy and surgery. […] The prognosis of gender dysphoria is generally positive and improves with treatment, which may include a combination of psychotherapy, hormones and surgery. […] These treatments are safe and effective in the long term, and very few people who chose surgical genital reassignment have regrets about their decision later in life.

• #68 Gender-affirming Care Saves Lives | Columbia University Department of Psychiatry

  https://www.columbiapsychiatry.org/news/gender-affirming-care-saves-lives

  Research demonstrates that gender-affirming care, a medical and psychosocial health care designed to affirm individuals’ gender identities, greatly improves the mental health and overall well-being of gender diverse, transgender, and nonbinary children and adolescents. […] Measures to restrict this critical care not only run counter to scientific evidence but also threaten the mental health of TGNB youth, many of whom experience gender dysphoria—clinically significant distress or impairment caused by a discrepancy between a person’s sex assigned at birth and their gender identity. […] Gender-affirming hormone therapy, which involves the use of feminizing or masculinizing hormones to allow the body to develop physical changes that align with a person’s gender identity, also significantly decreases gender dysphoria.

• #69 What is gender-affirming care? Your questions answered | AAMC

  https://www.aamc.org/news/what-gender-affirming-care-your-questions-answered

  One purpose of puberty blockers is to allow a young person time to fully determine their gender identity and how far they wish to transition before the onset of permanent sex characteristics. […] Hormone therapy: Older youths (usually in mid-adolescence) and adults can receive hormone therapy to increase their levels of estrogen or testosterone so that they develop sex characteristics more closely aligned with their gender identity. […] Criteria for gender-affirming care and therapy are provided in guidelines from several organizations, including the WPATH, the AAP, and the Endocrine Society. […] Studies have linked gender-affirming care at various levels to a decrease in depression and harmful behaviors. […] Providers attest to seeing positive changes in their patients from gender-affirming care. Most of them are happier, less depressed, and less anxious, says Adkins at the Duke Child and Adolescent Gender Care Clinic. Their schoolwork often improves, their safety often improves. […] Its important for providers to know that what they do, even if its just affirming someones [asserted] name, can have a positive influence on the health and development of that child.

• #70 HRC | Get the Facts on Gender-Affirming Care

  https://www.hrc.org/resources/get-the-facts-on-gender-affirming-care

  Prior research shows gender-affirming surgeries are both safe and positively received by patients. […] Gender-affirming care for transgender people is best-practice, medically necessary health care. […] A recent study from the Trevor Project shows that transgender youth with access to hormone replacement therapy medications have lower rates of depression and are at a lower risk for suicide. […] Previous research has found that transgender youth who are able to socially transition and simply have their gender identity, name, and pronouns affirmed report higher levels of resilience and positive well-being and lower levels of depression, anxiety, gender dysphoria, and suicidality, relative to transgender youth who are not affirmed. […] Previous studies have found that de-transitioning is quite rare with some studies finding levels of de-transition and regret as low as 1% or 2%.

• #71 What is gender-affirming care? Your questions answered | AAMC

  https://www.aamc.org/news/what-gender-affirming-care-your-questions-answered

  One purpose of puberty blockers is to allow a young person time to fully determine their gender identity and how far they wish to transition before the onset of permanent sex characteristics. […] Hormone therapy: Older youths (usually in mid-adolescence) and adults can receive hormone therapy to increase their levels of estrogen or testosterone so that they develop sex characteristics more closely aligned with their gender identity. […] Criteria for gender-affirming care and therapy are provided in guidelines from several organizations, including the WPATH, the AAP, and the Endocrine Society. […] Studies have linked gender-affirming care at various levels to a decrease in depression and harmful behaviors. […] Providers attest to seeing positive changes in their patients from gender-affirming care. Most of them are happier, less depressed, and less anxious, says Adkins at the Duke Child and Adolescent Gender Care Clinic. Their schoolwork often improves, their safety often improves. […] Its important for providers to know that what they do, even if its just affirming someones [asserted] name, can have a positive influence on the health and development of that child.

• #72 Gender Dysphoria: Causes, Symptoms, and Treatment

  https://patient.info/mental-health/gender-dysphoria-leaflet

  There are a number of different treatments for gender dysphoria. You may wish for one or some or all of them. […] Counselling and psychotherapy are talking treatments. Professionals help you explore your feelings and help you understand yourself better. […] Hormone treatment is not safe for everybody, and your specialist would check whether it is safe for you. […] Children with gender dysphoria may also be prescribed medication to block their own hormones. This is to stop them going past a certain stage of puberty. […] Most people who have had sex-changing treatment are happy with the results. Very few people regret making the change. […] Studies show people with gender dysphoria who have had sex-changing hormones and/or operations feel happier as a result. […] There can be problems following treatment, however, so it is very important to discuss these first with your specialist. […] People who have gender dysphoria may be more likely to have depression, have suicidal thoughts and die from suicide. So it may be helpful to take up the counselling or talking treatments you are offered.

• #73 Gender dysphoria is rising—and so is professional disagreement – BMJ Group

  https://bmjgroup.com/gender-dysphoria-is-rising-and-so-is-professional-disagreement/

  Gender dysphoria in young people is risingand so is professional disagreement. More children and adolescents are identifying as transgender and offered medical treatment, especially in the US. But some providers and European authorities are urging caution because of a lack of strong evidence. American medical professional groups are aligned in support of gender affirming care for gender dysphoria, which may include hormone treatment to suppress puberty and promote secondary sex characteristics, and surgical removal or augmentation of breasts, genitals, and other physical features. Three organisations in particular have had a major role in shaping the US approach to gender dysphoria care: The World Professional Association for Transgender Health (WPATH), the American Academy of Pediatrics, and the Endocrine Society, all of which have guidelines or policies that support early medical treatment for gender dysphoria in young people. These endorsements are often cited to suggest that medical treatment is both uncontroversial and backed by rigorous science, but governing bodies around the world have come to different conclusions regarding the safety and efficacy of certain treatments. For example, Swedens National Board of Health and Welfare, which sets guidelines for care, determined earlier this year that the risks of puberty blockers and treatment with hormones currently outweigh the possible benefits for minors. And NHS England, which is in the midst of an independent review of gender identity services, recently stated that there is scarce and inconclusive evidence to support clinical decision-making for minors with gender dysphoria, and that for most who present before puberty it will be a transient phase, requiring clinicians to focus on psychological support and to be mindful of the risks of even social transition. Despite these concerns, WPATH recommends that youth have access to treatments following comprehensive assessment, stating the emerging evidence base indicates a general improvement in the lives of transgender adolescents. Eli Coleman, lead author of WPATHs Standards of Care and former director of the Institute for Sexual and Gender Health at the University of Minnesota, told The BMJ that WPATHs new guidelines emphasise careful assessment prior to any of these interventions by clinicians who have appropriate training and competency to assure that minors have the emotional and cognitive maturity to understand the risks and benefits. But without an objective diagnostic test, others remain concerned, pointing to examples of teenagers being fast-tracked to medical intervention with little or no mental health involvement. And in her interim report of a national review into services for young people with gender identity issues, Hilary Cass noted that some NHS staff reported feeling under pressure to adopt an unquestioning affirmative approach and that this is at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters.

• #74

  https://www.nhs.uk/conditions/gender-dysphoria/treatment/

  It’s important to remember that hormone therapy is only one of the treatments for gender dysphoria. Others include voice therapy and psychological support. The decision to have hormone therapy will be taken after a discussion between you and your clinic team. […] There is some uncertainty about the risks of long-term cross-sex hormone treatment. The clinic will discuss these with you and the importance of regular monitoring blood tests with your GP. […] Some people may decide to have surgery to permanently alter body parts associated with their biological sex. […] Whether you’ve had hormone therapy alone or combined with surgery, the aim is that you no longer have gender dysphoria and feel at ease with your identity.

• #75 Home | SEGM

  https://segm.org/

  Psychologist David Schwartz, Ph.D. exhorts clinicians to treat children and adolescents with gender dysphoria using psychotherapy rather than pharmacological and surgical interventions. […] The National Academy of Medicine in France has issued a press release in which it cautions medical practitioners that the growing cases of transgender identity in young people are often socially-mediated and that great caution in treatment is needed. […] The official journal of the German Medical Association published an article on the controversies in youth gender transition, stating that „the scientific evidence that these therapies are more beneficial than harmful is not as robust as has long been proclaimed.” […] The Society for Evidence-Based Gender Medicine (SEGM) maintains that treatments for gender-dysphoric people should be supported by high quality evidence.

• #76 Gender dysphoria is rising—and so is professional disagreement – BMJ Group

  https://bmjgroup.com/gender-dysphoria-is-rising-and-so-is-professional-disagreement/

  Gender dysphoria in young people is risingand so is professional disagreement. More children and adolescents are identifying as transgender and offered medical treatment, especially in the US. But some providers and European authorities are urging caution because of a lack of strong evidence. American medical professional groups are aligned in support of gender affirming care for gender dysphoria, which may include hormone treatment to suppress puberty and promote secondary sex characteristics, and surgical removal or augmentation of breasts, genitals, and other physical features. Three organisations in particular have had a major role in shaping the US approach to gender dysphoria care: The World Professional Association for Transgender Health (WPATH), the American Academy of Pediatrics, and the Endocrine Society, all of which have guidelines or policies that support early medical treatment for gender dysphoria in young people. These endorsements are often cited to suggest that medical treatment is both uncontroversial and backed by rigorous science, but governing bodies around the world have come to different conclusions regarding the safety and efficacy of certain treatments. For example, Swedens National Board of Health and Welfare, which sets guidelines for care, determined earlier this year that the risks of puberty blockers and treatment with hormones currently outweigh the possible benefits for minors. And NHS England, which is in the midst of an independent review of gender identity services, recently stated that there is scarce and inconclusive evidence to support clinical decision-making for minors with gender dysphoria, and that for most who present before puberty it will be a transient phase, requiring clinicians to focus on psychological support and to be mindful of the risks of even social transition. Despite these concerns, WPATH recommends that youth have access to treatments following comprehensive assessment, stating the emerging evidence base indicates a general improvement in the lives of transgender adolescents. Eli Coleman, lead author of WPATHs Standards of Care and former director of the Institute for Sexual and Gender Health at the University of Minnesota, told The BMJ that WPATHs new guidelines emphasise careful assessment prior to any of these interventions by clinicians who have appropriate training and competency to assure that minors have the emotional and cognitive maturity to understand the risks and benefits. But without an objective diagnostic test, others remain concerned, pointing to examples of teenagers being fast-tracked to medical intervention with little or no mental health involvement. And in her interim report of a national review into services for young people with gender identity issues, Hilary Cass noted that some NHS staff reported feeling under pressure to adopt an unquestioning affirmative approach and that this is at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters.

• #77 FAQ: Equal Access to Health Care | Lambda Legal Legacy

  https://legacy.lambdalegal.org/know-your-rights/article/trans-related-care-faq

  Yes, doctors have found such treatments to be medically necessary for many people. The AMAs 2008 resolution recognized an established body of medical research that demonstrates the effectiveness and medical necessity of mental health care, hormone therapy, and gender-affirming surgery as forms of therapeutic treatment for many patients diagnosed with [gender dysphoria]. […] Courts have repeatedly ruled that these treatments may be medically necessary and have recognized gender dysphoria as a legitimate medical condition constituting a serious medical need (see Lambda Legals victory in Fields v. Smith). Courts have also found that psychotherapy alone can be insufficient treatment for gender dysphoria, and that for some people, gender-affirming surgery may be the only effective treatment. […] The myth that transition-related care is cosmetic or experimental is discriminatory and out of touch with current medical thinking.

• #78 Supporting autonomy in young people with gender dysphoria: psychotherapy is not conversion therapy | Journal of Medical Ethics

  https://jme.bmj.com/content/51/1/3

  Psychotherapy empowers gender-distressed youth to make truly informed choices about their lives. […] The NHS has recently emphasised that gender dysphoria may in fact be secondary to other difficulties. […] The reality is that many, if not most, young people are not offered the opportunity to engage in self-reflection with the support of a qualified clinician in order to understand themselves more deeply before undergoing medical gender transition. […] The inclusion of psychotherapeutic exploration in the response to young people with gender distress is not based on a moral imperative but on an ethical one.

• #79 Transgender Issues and Gender Dysphoria treatment in Orange county CA

  https://harbormentalhealth.com/conditions-treated/transgender-issues-and-gender-dysphoria/

  The goal is to help patients gain confidence and clarity as they explore their feelings about their gender and continue along their journey of self-discovery. […] Medical care consists of hormone therapy and/or surgery: Hormone therapy is used to feminize or masculinize a persons body, to different degrees, depending on the individuals wishes. […] There is no one-size-fits-all treatment for gender dysphoria. If you suffer from gender dysphoria, it is essential to seek a provider who is not only knowledgeable in the benefits and risks of various approaches to reducing gender dysphoria but also willing to work with you to create an individualized treatment that best meets your specific needs and goals.

• #80 Gender dysphoria Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/gender-dysphoria

  Gender dysphoria is the term for a deep sense of unease and distress that may occur when your biological sex does not match your gender identity. […] The main goal of treatment is to help you overcome the distress you may feel. You can choose the level of treatment that helps you feel most comfortable. This may include helping you transition to the gender you identify with. […] Treatment for gender dysphoria is individualized, and may include: Counseling to help you understand your feelings and to provide you with support and coping skills, Couples or family counseling to help reduce conflicts, create understanding, and provide a supportive environment, Gender-affirming hormone therapy (in the past called hormone replacement therapy), Gender-affirming surgery (in the past called sex-reassignment surgery).

• #81 Gender Dysphoria Treatment | Good Health Psychiatric Services

  https://goodhealthpsych.com/gender-dysphoria-treatment/

  First, an evaluation is done to provide a diagnosis and then determine the best course of treatment. If you are experiencing gender dysphoria, access to gender-affirming healthcare is important to support the person’s wellbeing. […] Gender dysphoria can be upsetting, perplexing, and uncomfortable for many people. It does not lead to mental health issues, but those who experience the condition may also have despair, anxiety, or other difficulties with their mental and emotional health, frequently as a result of negative social stigma, transphobia, and damaging stereotypes. […] Primary care doctors frequently play an active role in the diagnosis and start of the treatment of gender dysphoria. However, a trained psychologist or psychiatrist is preferentially used to diagnose gender dysphoria.

• #82 Gender Dysphoria: Causes, Symptoms, and Treatment

  https://patient.info/mental-health/gender-dysphoria-leaflet

  There are a number of different treatments for gender dysphoria. You may wish for one or some or all of them. […] Counselling and psychotherapy are talking treatments. Professionals help you explore your feelings and help you understand yourself better. […] Hormone treatment is not safe for everybody, and your specialist would check whether it is safe for you. […] Children with gender dysphoria may also be prescribed medication to block their own hormones. This is to stop them going past a certain stage of puberty. […] Most people who have had sex-changing treatment are happy with the results. Very few people regret making the change. […] Studies show people with gender dysphoria who have had sex-changing hormones and/or operations feel happier as a result. […] There can be problems following treatment, however, so it is very important to discuss these first with your specialist. […] People who have gender dysphoria may be more likely to have depression, have suicidal thoughts and die from suicide. So it may be helpful to take up the counselling or talking treatments you are offered.

• #83 Gender Dysphoria | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/gender-dysphoria

  Gender-affirming psychotherapy provides a safe environment in which children, adolescents, and adults can safely explore their gender identity and find a comfortable gender expression. The goal of gender-affirming therapy is to facilitate identity development across the lifespan, assist individuals and their families in coping with any social stigma they may encounter, and promote resilience. […] A family based approach is also highly recommended for children and adolescents with gender dysphoria. Family approaches emphasize the role of parents and other family members in treatment. This can include family sessions or parent groups that empower family members with tools to help in improving their relationship and communication within the family and to support the gender journey of their child.

• #84 What Is Gender Dysphoria? | Lyra Health

  https://www.lyrahealth.com/blog/what-is-gender-dysphoria/

  The World Professional Association for Transgender Health (WPATH) developed clinical guidelines for standards of care and best practices in health care for transgender and gender-diverse people based on the latest science and expert professional consensus. […] Some ways professionals can support and care for gender-diverse people in culturally responsive ways include: Educating clients on options for medical interventions like feminizing hormone therapy and surgery, masculinizing hormone therapy and surgery, and puberty blockers. […] The hope is that the term gender dysphoria highlights the identity stress people experience that may lead them to seek mental health care.

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