Hormone Replacement Therapy in Transgendering the FTM Transsexual

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Hormone Replacement Therapy in Transgendering the FTM Transsexual

Gender may well be the most defining factor in the spectrum of elements that comprise the human persona. In fact gender is so basic to our identity, most people mistakenly assume that our sense of being male or female is defined with absolute certainty by our anatomical sex. Contrary to popular belief, our sense of gender and anatomical sex are two distinct elements; each developing at different times in different parts of the body. While my research is limited to hormone replacement therapy involved in masculinizing a biological female, it should be noted that the psychiatric, psychological, and medical factors that contribute to cases of gender dysforia are major areas of concern in its treatment. The general goal of psychotherapeutic, endocrine, or surgical therapy for persons with gender identity disorders is lasting personal comfort with the gendered self in order to maximize overall psychological well-being and self-fulfillment.

Introductory Concepts

The Syndrome

Transsexualism is a Gender Identity Disorder (GID) in which there is a strong and on-going cross-gender identification (a desire to live and be accepted as a member of the opposite sex). There is a persistent discomfort with his or her anatomical sex and a sense of inappropriateness in the gender role of that sex. There is a wish to have hormonal treatment and surgery to make one's body as congruent as possible with one's psychological sex.

Treatment

The currently accepted and effective model of treatment utilizes hormone therapy and surgical reconstruction and may include counselling and other psychotherapeutic approaches. In all cases, the length and kind of treatment provided w...

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It is now certain that androgen treatment has an unfavorable effect on the lipid profile. It places female-to-male transsexuals in the risk category of men; therefore, patients must be advised not to smoke, to exercise moderately, and to prevent extreme weight gain and high blood pressure. After surgical sex reassignment including ovariectomy, androgen therapy must be continued to prevent symptoms of hormone deprivation and osteoporosis. Discontinuation of cross-sex hormones following surgical adaptation to the desired sex leads to loss of bone mineral density. It is necessary to temporarily discontinue sex steroid administration 3-4 weeks before any elective surgical intervention. Immobilization is a trombogenic risk factor and sex steroids may aggravate the risk of thromboembolism. Once subjects are fully mobilized again, hormone therapy may be reinstated.

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