Gender-affirming hormone therapy (GAHT), when provided through informed-consent and evidence-based monitoring, represents safe, effective, and life-affirming care that aligns secondary sex characteristics with gender identity and improves psychological well-being, quality of life, and social functioning.
Key Findings
Background
Gender-affirming medical treatment effectively aligns secondary sex characteristics with gender identity and improves psychological well-being, quality of life, and social functioning.
The article synthesizes current evidence and guideline recommendations for both feminizing and masculinizing GAHT
Outcomes include improvements in psychological well-being, quality of life, and social functioning
The review covers dosing strategies, monitoring protocols, fertility counseling, and management of common side effects
Conclusions
GAHT provided through informed-consent and evidence-based monitoring is characterized as safe and effective care.
The article frames GAHT as 'safe, effective, and life-affirming care' when delivered through informed-consent models
Evidence-based monitoring protocols are identified as a key component of safe delivery
The review covers both feminizing and masculinizing hormone therapy approaches
Conclusions
Optimizing low-dosing protocols for nonbinary patients is identified as a future priority in gender-affirming care.
Current evidence and guidelines do not fully address the needs of nonbinary patients
Low-dosing protocols represent a gap in current gender-affirming medical treatment literature
The authors identify this as a future research and clinical priority
Methods
Fertility counseling is identified as a necessary component of gender-affirming hormone therapy protocols.
Fertility counseling is listed alongside dosing strategies and monitoring protocols as a core element of GAHT management
The article synthesizes current guideline recommendations regarding fertility counseling for transgender and gender-diverse individuals
This applies to both feminizing and masculinizing hormone therapy contexts
Conclusions
Continued innovation and global research are identified as essential to advance equity and ensure high-quality gender-affirming medicine.
The authors call for 'continued innovation and global research' as essential next steps
Equity is explicitly named as a goal of future research efforts
The article frames global research as necessary to ensure high-quality care for all transgender and gender-diverse individuals
What This Means
This research article reviews the current state of medical treatments that help transgender and gender-diverse people align their physical characteristics with their gender identity. Specifically, it focuses on hormone therapy — medications that produce feminizing or masculinizing physical changes — and summarizes what the medical literature and clinical guidelines recommend regarding how to prescribe these medications, monitor patients over time, discuss fertility options, and manage side effects. The authors conclude that when hormone therapy is provided carefully, with informed consent and evidence-based monitoring, it is a safe and effective form of care that meaningfully improves patients' mental health, quality of life, and social functioning.
The review also highlights that people who identify as nonbinary — neither exclusively male nor female — may benefit from lower doses of hormone therapy that produce partial rather than full physical changes, and that developing clearer protocols for this approach is an important goal for future research. The article emphasizes that fertility counseling should be a routine part of care, since hormone therapy can affect a person's ability to have biological children.
This research suggests that gender-affirming hormone therapy, delivered through a model that emphasizes patient education, consent, and ongoing medical monitoring, represents a well-supported medical intervention. The authors call for continued research, particularly on a global scale, to improve access and quality of care for all transgender and gender-diverse individuals, with equity as an explicit priority.
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Hastie E, Bortner A, Wagner G, Blumenthal J. (2026). Gender-Affirming Medical Treatment of Transgender and Gender-Diverse Individuals.. Obstetrics and gynecology clinics of North America. https://doi.org/10.1016/j.ogc.2025.12.002