Skip to main content

Approach to transgender individuals

Abstract

Background

Trans-sexualism is the desire to be a member of the opposite sex during normal somatic sexual development. In this study, we would like to share our endocrinological approach and general clinical features of the patients with gender identity disorder.

Patients and methods

General and clinical features of 63 patients who were referred to Endocrinology Department between October 2012 and March 2014 were investigated retrospectively. In the beginning of the therapy, and later periodically, the patients were physically examined and their basal hormones and biochemical data were evaluated.

Results

Forty-eight (76.2%) patients constituted the female-to-male (FtM) group, and 15 (23.8%) patients constituted the male-to-female (MtF) group. The mean age was 25.0±4.6 in the FtM group and 24.9±5.9 in the MtF group. In the FtM group, 28 patients used testosterone preparations as cross-sex hormone, whereas 20 did not. Five (10.4%) patients had already used this preparation before they applied to us. Seven patients underwent mastectomy and four underwent oophorectomy. Penile prosthesis was implanted in one patient with reconstructive surgery. In the MtF group, nine patients used estradiol preparation. In the MtF group, three patients underwent breast implant surgery. Reconstructive surgery or orchiectomy was not performed.

Conclusion

The cross-sex hormone therapy provides the development of secondary sex characteristics and must also be given as a replacement therapy after gonadectomy.

References

  1. Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA. Endocrine Society. An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2009; 94:3132–3154.

    CAS  PubMed  Google Scholar 

  2. Costa EM, Mendonca BB. Clinical management of transsexual subjects. Arq Bras Endocrinol Metabol 2014; 58:188–196.

    Article  Google Scholar 

  3. Childs JM. Transsexualism: some theological and ethical perspectives. Dialog J Theol 2009; 48:30–41.

    Google Scholar 

  4. International Statistical Classification of Diseases and Related Health Problems, Section V Mental and behavioural disorders, F64 Gender identity disorders, 10th Revision, Version 2015.

  5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Press Inc; 2013.

  6. Adrenal ve Gonadal Hastalıklar Kılavuzu 2014. Available at: http://www.turkendokrin.org/files/file/ADRENAL_TTK_web.pdf.

  7. International Journal of Transgenderism. 2012; 13:165–232. doi:10.1080/15532739.2011.700873.

  8. Olyslager F, Conway L. On the calculation of the prevalence of transsexualism. Chicago, Illinois, USA: WPATH 20th International Symposium; 6 September 2007.

  9. Veale FV. Prevalence of transsexualism among New Zealand passport holders. Aust N Z J Psychiatry 2008; 42:887–889.

    Article  Google Scholar 

  10. Zhau JN, Hofman MA, Gooren LJ, Swaab DF. A sex difference in the human brain and its relation to transsexuality. Nature 1995; 378:68–70.

    Article  Google Scholar 

  11. Zucker KJ, Bradley SJ, Oliver G, Blake J, Fleming S, Hood J. Psychosexual development of women with congenital adrenal hyperplasia. Horm Behav 1996; 30:300–318.

    Article  CAS  Google Scholar 

  12. Bosinski HAG, Peter M, Bonatz G, Arndt R, Heidenreich M, Sippell WG, Wille R. A higher rate of hyperandrogenic disorders in female-to-male transsexuals. Psychoneuroendocrinology 1997; 22:361–380.

    Article  CAS  Google Scholar 

  13. Baba T, Endo T, Ikeda K, Shimizu A, Honnma H, Ikeda H, et al. Distinctive features of female-to-male transsexualism and prevalence of gender identity disorders in Japan. J Sex Med 2011; 8:1686–1693.

    Article  Google Scholar 

  14. Royal College of Psychiatrists. Good practice guidelines for the assessment and treatment of adults with gender dysphoria. London: Royal College of Psychiatrists; 2013.

  15. Turkish Civil Code, Law N. 4721, dated 7/12/2002, Article 40, Ankara.

  16. Asscheman H, Giltay EJ, Megens JA, de Ronde WP, van Trotsenburg MA, Gooren LJ. A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. Eur J Endocrinol 2011; 164:635–642.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nilufer O. Kutbay MD.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kutbay, N.O., Yurekli, B.S., Baykan, E.K. et al. Approach to transgender individuals. Egypt J Intern Med 29, 1–4 (2017). https://doi.org/10.4103/1110-7782.207782

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1110-7782.207782

Keywords