World Professional Association for Transgender Health's Standards of Care Requirements of Hormone Therapy for Adults with Gender Identity Disorder

Hormone therapy is one of the major steps in the transition from one gender to the other. The influence of hormones is profound and they change body image significantly. For an individual to begin hormone therapy, he/ she needs to meet specific eligibility and readiness criteria that include taking other social/ personal steps toward transition to the newgender and developing a thorough understanding of the medical and social risks and benefits of sex hormones. There are very few studies examining these specific eligibility and readiness criteria. However using these criteria, the long-term outcomes of individuals undergoing transition have improved since the establishment of the criteria in the SOC in 1980. Several specific questions are not addressed in the current Standards of Care (SOC). (1) Is there a role for blocking sex hormones in these adults as there is in adolescents? Some transgender individuals are focused on getting rid of endogenous sex hormones and their effects such as menstruation. They initially are not interested in the cross sex hormones, but are interested in hormone blockers. (2) Is it appropriate to prescribe cross-sex hormones for individuals who do not desire to have sex-reassignment surgery? Some transgender individuals are happy and content with hormone therapy alone. (3) Is there a role for a hormone-treatment test? The early SOC acknowledged its usefulness but subsequent versions have not addressed the issue. There is essentially no published data on these issues. More studies are definitely needed to examine when the sex hormone therapy should be used and the form it should take.