Gender-affirming hormone treatment modalities for transfemale & non-binary transfeminine individuals: A UK perspective.

The number of people seeking gender-affirming hormone treatment has dramatically risen in the last two decades.

• Gender incongruence and referrals for gender-affirming hormone treatment have increased dramatically over the last two decades in the UK.
• The paper identifies this rise as a key motivating factor for providing updated clinical guidance.

UK standard practice for transfeminine individuals involves simultaneous testosterone suppression via anti-androgens and exogenous oestradiol replacement.

• Both transgender women and non-binary transfeminine individuals are treated under this dual-approach protocol.
• Anti-androgens are used to suppress endogenous testosterone production.
• Exogenous oestradiol is administered as replacement therapy alongside anti-androgens.

Oestrogen replacement in the UK is primarily administered via transdermal or oral preparations.

• Transdermal preparations include gel and patch formulations.
• Oral preparations are also commonly used.
• Preparation choice is based on a combination of individual preference and mitigation of complications based on individual risk profiles.

Time frames to achieve female physical changes following gender-affirming hormone treatment are described as largely predictable.

• The paper emphasizes that managing expectations of individuals prior to commencing treatment is 'highly important.'
• Predictability of physical change timelines is presented as a key counselling point.

Common complications of gender-affirming hormone treatment in transfeminine individuals include venous thromboembolism, liver dysfunction, and effects on fertility.

• Venous thromboembolism is identified as a significant complication requiring pre-treatment counselling.
• Liver dysfunction is noted as a complication associated with hormone treatment.
• Effects on fertility are highlighted as an important consideration, requiring thorough counselling prior to commencing treatment.
• The paper states individuals 'should be thoroughly counselled prior to commencing treatment' regarding these risks.