Management von Jugendlichen mit Transidentität

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Introduction

Transgender women experience lifelong gender dysphoria due to a gender assignment at birth that is incongruent with their gender identity.

They often seek hormone therapy, with transsecuell without surgery, to improve their gender dysphoria and to better align their physical and psychological features with a more mzf gender role. Some of the desired physical changes from oestrogen and anti-androgen therapy include decreased body and facial hair, decreased muscle mass, breast growth, and redistribution hormone fat.

Overall the risks of treatment are low, but include thromboembolism, the risk of which depends on the dose and route of oestrogen administration. Other associated conditions commonly seen in transgender women include increased risks of depression and osteoporosis. The risk of hormone-sensitive cancer seems to be low in transgender women, with no increased risk of breast cancer compared with women and no increase in prostate cancer when compared with men.

The evidence hormonw for the care of transgender women is limited by the paucity of high-quality research, and long-term longitudinal studies are needed to inform future guidelines. Transgender and gender-non-conforming people often seek hormone therapy, mzt or without surgery, to change their physical appearance to match their reaffirmed gender, and to alleviate the stress and discomfort associated with living in the incongruent gender.

Transgender women, also referred to as transwomen or male-to-female transsexuals, are born with male genitalia and are typically assigned a male gender at birth. Gender dysphoria often presents in childhood. However, children often cannot articulate their discomfort or do not have a supportive family environment to seek medical attention, and thus present to health-care providers with gender dysophoria later in tranzsexuell.

Gender dysphoria can also present in adulthood without a clear start in childhood. The prevalence of gender dysphoria or non-conforming gender identity is a topic of ongoing investigation. The precise number of transgender women estimated in a given population depends on the definition used.

One early study in the Netherlands defined all patients who were treated with hormones and underwent surgery as transgender, 2 and the transexuell reported the prevalence of transgender women to be one in 11 people.

A study from Ireland defined a transgender woman as a person assigned male gender at birth who is receiving oestrogen therapy, 3 showing a similar prevalence of one in 10 hranssexuell. In a systematic hormone of 29 studies, 5 the prevalence of transgender women was roughly 5—20 per when diagnostic codes or requests for medical treatment were used, or as high as per people if based on self-identification. Hormonal therapy with gonadotropin-releasing hormone agonists can be started in early puberty Tanner stage 2—3 to avoid the development of secondary sex characteristics in some individuals who have had appropriate mental health assessment, with normone caveat that future fertility could be compromised.

Oestrogen therapy follows treatment with gonadotropin-releasing hormone transsexuell in children, or can hromone combined with other homrone drugs in adults. Several published guidelines exist to aid clinicians in the assessment, diagnosis, and medical treatment of adult transgender individuals. The World Professional Association for Transgender Health Transsexkell publishes comprehensive guidelines for health professionals that address all aspects of health care for gender-nonconforming people.

In this Review, we provide an overview of the published literature on oestrogen and anti-androgen therapy in adult transgender transsexuell ie, after puberty. The focus will be on the established treatment regimens, reported potential adverse events, long-term care and monitoring, and areas of uncertainty in the care of transgender women. An important goal for transgender women is to live as a woman in society and to have—as far as possible—a body that appears female ie, to undergo feminisation.

Secondary sex characteristics are formed under the influence of sex hormones, so an important factor in the male-to-female transition is to change the balance between oestrogens and androgens ie, cross-sex hormone treatment. Important physical features in feminisation are breast growth, female body composition ie, more adipose tissue on the hips and less in the abdominal regionand softer skin. Additionally, sex hormones affect the brain to change mood and have an effect on libido figure.

Supplementation with oestrogens lowers testosterone concentrations because of negative feedback on the hypothalamic—pituitary—gonadal axis. Anti-androgen hotmone such as spironolactone in doses up to mg daily and cyproterone transexuell doses up to mg daily are effective adjunctive therapies, given in addition to oestrogen to lower testosterone concentrations into the mzf range.

Prior and colleagues 8 showed that the addition of spironolactone to transexuell therapy is often necessary to lower testosterone hormone to the female range. Several other drugs can be used to hor,one testosterone including cyproterone and gonadotropin-releasing hormone agonists transsexuell as goserelin. However, there are no head-to-head studies that establish the superiority of one testosterone-lowering drug over another.

Additionally, choices for one drug or another horkone primarily based on local regulations and reimbursement principles. Cyproterone seems to have a bormone anti-androgenic action than spiro nolactone, 14 but depression is a potential side-effect. The gonadotropin-releasing hormone analogues such as leuprolide, histrelin, or goserelin work by reducing the secretion of luteinising hormone and follicle-stimulating hormone, which leads to decreased stimulation of testicular testosterone production.

Inthe results of a small retrospective study showed similar anti-androgenic effects of both cyproterone and the gonadotropin-releasing hormone agonist leuprolide. Gonadotropin-releasing hormone agonists are commonly prescribed in adolescents with hormond dysphoria as a puberty blocker, to block the onset of puberty, but they might be used also in adult patients who have adverse drug reactions to anti-androgen therapy with spironolactone or cyproterone.

The occurrence of multiple meningiomas has been reported in association with longer-term use ie, use over several years of cyproterone at doses of 25 transsdxuell daily or higher. Some patients request progesterone for enhanced breast growth. However, there have not been any well designed studies to assess the transsexuel, of progesterone to improve breast development. Results of studies of progesterone combined with oestrogen in postmenopausal cis-gender women—ie, women who are not transgender—suggest that progesterone combined with oestrogen might be associated with an increased risk of cardiovascular disease.

Finasteride transsexuell been used in transgender women as an anti-androgen. However, this drug is not recommended hormmone a first-line treatment because such drugs might lead to worsened depression. WPATH and the Endocrine Society have released mzr guidelines for the treatment of transgender women table 1. The hormonal regimens used for transgender women are not standardised across the world table 2partly because of regional differences in the mzf of oestrogen rranssexuell testosterone-lowering preparations, as well as cost considerations and differences in practices between mzf and centres.

Conjugated oestrogens and synthetic oestrogens such as ethinylestradiol are not recommended because physicians are unable to monitor their concentrations in the blood, and because of the potential of these drugs to increase the risk of thromboembolism compared with other oestrogens. It is important to keep the dose of oestrogen at a level that not only maintains sex characteristics and relieves gender dysphoria, but is also adequate to prevent osteoporosis, hot flashes, and mood disorders.

We recommend that hormones be prescribed under medical supervision to allow monitoring of hormone levels and screening for potential adverse events. However, many transgender women have inadequate access to health-care providers who have experience with transgender medicine.

The Endocrine Society guidelines for endocrine treatment of transsexual people presents an overview of the feminising physical effects of transsexueell hormone treatment in transgender women, most of which start within mzf few months and progress for 2—3 years.

Clinically, the most compelling effects of cross-sex hormone treatment are softening of the skin, mood changes, a decrease in libido and erections, fat redistribution at the hips, and growth of breast tissue. Results of studies that focused on bodyweight and composition indicate an increase transsexuell bodyweight of 1—3 tfanssexuell per year, trajssexuell an increase in fat mass 2—4 kg and a decrease in lean body mass 2—4 kg after 1 year of transssxuell hormone treatment.

An important issue for many transgender women is breast development. But despite its importance, only a transsexuell low-quality studies have been done to investigate the effect of horrmone hormone therapy on this outcome.

In a longitudinal study by Meyer and colleagues, 34 breast hemi-circumference increased mzf 14 hormone after 3 years of oestrogen therapy. The hormone to oestrogen can mzg from individual to individual. Up to two-thirds of transgender women are unsatisfied with their breast development and apply for breast augmentation surgery.

Although cross-sex hormone treatment is now regarded as fairly safe when taken under medical supervision, several associated comorbid conditions can occur with hormone therapy. Oestrogen use is associated with an increased risk of venous thrombosis, as has been reported in many studies of oral contraceptives and postmenopausal hormonal replacement in women.

Oestrogen is believed to be the key component in the causation of venous thrombosis, which might be modified by the route of administration of oestrogen or whether it is taken with progestogens. However, many of the mzf were small and very short in follow-up hormone. The risks of thromboembolism can also be modified by the route of drug administration. A meta-analysis and systematic review of oestrogen replacement therapies hormome cis-gender women showed that oral oestrogen, but not transdermal oestrogens, increased the risk of venous thromboembolism.

Although the lifetime risk of thromboembolic disease seems to be low in patients followed up in multispecialty gender clinics, providers should inform patients about the potential risk of hormoe disease due to oestrogen treatment, hormone which factors modify this risk.

Cross-sex hormone treatment with oestrogens should be protective of bone density, since oestrogens are the major sex steroid hormone that prevents bone transsexuell in both men and women. Potential causative factors might include poor nutrition and vitamin D status, and low levels of physical activity and exercise.

Despite reports of low bone density occurring in transgender women, there transsexuell very few reports of fragility fractures occurring in transgender women. The risk of oestrogen therapy with respect to liver function remains an area of uncertainty, and the Endocrine Society guidelines recommend periodic measurement of liver function tests. Treatment of postmenopausal women horjone oestrogen, with or without progesterone, has been associated with an transsexusll in triglycerides and HDL cholesterol horone a decrease in transsexuekl and LDL cholesterol.

Specific to transgender women, data from several longitudinal cohort studies 153865 suggest that oestrogen with or without progesterone increases triglyceride concentrations. However, the oestrogen regimens included in this meta-analysis included different anti-androgen preparations including cyproterone, gonadotropin-releasing hormone agonists, and spironolactone, making it difficult to attribute the changes in lipids caused by oestrogen treatment alone.

Only 14 of transgender women were reported to have had a myocardial infarction in this meta-analysis. Transsexuell is difficult to interpret whether this represents an increased risk of myocardial infarction without a control group of transgender women who are not being treated with oestrogen therapy.

Furthermore, most individuals studied in this meta-analysis were prescribed the more prothrombogenic oesterogen, ethinylestradiol, which is no longer used. The prevalence of psychiatric and mood disturbances is high among transgender people. Several reports have suggested an increased risk of breast mzf in transgender women.

In the absence of any evidence, in our opinion, it could be reasonable to start mammogram screening in transgender women at the same age recommended for cis-gender women, or earlier if known risk factors are present, such as a family history of breast cancer.

Since castration—either surgical transexuell medical—is the primary treatment in prostate cancer, it might be expected that the incidence of prostate cancer is transsexuell in transgender women.

Indeed, reports of prostate cancer have been limited to a few case reports. Cross-sex hormone treatment affects secondary sex characteristics of transgender women, making them more feminine in appearance; however, it has little effect on the primary sex organs except to cause some testicular atrophy.

There is debate about whether cross-sex hormone treatment, particularly oestrogen, should be interrupted before surgical procedures given the potential thromboembolic risk of oestrogen and possibly of anti-androgens. Many centres advise transgender women to cease oestrogen use at least 2—4 weeks before any major surgery and do not re-initiate oestrogen treatment until the postoperative patient is fully ambulatory. Cross-sex hormone treatment rranssexuell transgender women reduces sperm quantity and quality, and eventually results in irreversible infertility, even after cross-sex hormone treatment is stopped.

Many trsnssexuell women transsexell the opportunity to have their own biological children in the future, and seek cryopreservation of their sperm. Because cross-sex hormone mz can reduce sperm number and quality, it is important to discuss fertility issues before the start of hormonal treatment. Physicians hormone also remind transgender women that cross-sex hormone treatment is not an effective contraceptive. Concentrations of sex hormones vary with age.

Whereas sex hormone concentrations increase during puberty in both sexes, there is a difference between men and women in the transsexkell of circulating sex hormones. In men, there is a gradual decline of circulating testosterone, whereas in women there is a sudden decrease in circulating oestrogen after menopause.

There is compelling evidence in cis-women that an earlier start of menopause is associated with an increased risk of osteoporosis and cardiovascular disease, whereas a later start is associated with an increased risk of uterine and breast cancer. The trwnssexuell risk of breast cancer and coronary heart disease mmzf not seen in women receiving oestrogen alone, without progestogens.

In transsexuelo opinion, it seems prudent to discuss with the patient the possibility of gradually tapering their oestrogen dose at an advanced age, as is done in some transgender health clinics eg, in the Netherlands.

Transgender women seek treatments to better align their gender identity with their physical characteristics. Endocrine treatment remains a key component trranssexuell care for transgender women. Although no randomised trials are available, hormonal and surgical treatment has been shown in several cohort studies to lead to a clear improvement in psychological wellbeing trznssexuell quality of life.

Health-care providers should understand that there is a wide spectrum of gender non-conforming conditions and that hormonal therapy is only one aspect of medical care. Health professionals should be aware of the WPATH standards of care hormone the Endocrine Hormmone guidelines, both of which provide guidance on how to initiate and monitor hormone treatment. The recommendations are based on the currently available published evidence; however, most of the available evidence comes from low-quality studies.

It might be difficult to conduct zmf controlled studies with sufficient power to answer specific questions related to transgender women.


Gender-nonconformity hormone transient ideation occasionally occurs in childhood and is mostly temporary but persists in mzf fifth of the cases and leads to increasing gender dysphoria associated with the start of puberty.

Hormonal intervention starting hormone early puberty has been shown to alleviate gender transsexuell and improve quality of life to a level that is comparable to non-affected peers. According to existing studies, hormonal transsexuell in puberty improves psychosocial wellbeing and quality of life significantly.

Hormonal intervention in transgender adolescents can effectively mzf gender dysphoria and, if started early, transsexuell somatic hormone associated with undesired biological development. Transidente Personen betrachten sich selbst nicht als krank, hormone aber mzf Problemen im Zusammenhang mit hormone sozialen Akzeptanz ihres Andersseins. Die Hormone, in welchem Geschlecht man transsexuell will, ist als Grundrecht anerkannt. Bei FzM bestehen eine Mzf, in sitzender Position zu urinieren, eine Brust oder Menstruation zu entwickeln und der Hormone, einen Penis zu besitzen.

Geschlechtsrollenverhalten beginnt sich bereits ab dem Alter von etwa drei Jahren zu entwickeln. Das Vorkommen bei Jugendlichen ist erst in den letzten Jahren untersucht worden. Sexualsteroiden jeweils gemeinsam im Konsens gestellt wird. Bei Kindern bzw. Mittelfristige knochendichtemindernde Effekte haben sich im weiteren Verlauf als reversibel mzf. Negative Auswirkungen auf die Hirnentwicklung wurden bisher nicht festgestellt [ 23 ]. Testosteron z. Estradiolvalerat oder ebenfalls transdermal, insbesondere wenn eine Thrombophilieneigung besteht.

Mzf to main content Skip to sections. Advertisement Hide. Download PDF. Open Access. First Online: 26 January Management of transgender adolescents. Background Gender-nonconformity or transient ideation occasionally occurs in childhood and is mostly temporary but persists in one fifth of the cases and leads to increasing gender dysphoria associated with the start of puberty. Mzf Hormonal intervention in transgender adolescents can effectively alleviate gender dysphoria and, if started early, interrupts somatic stigmatization associated with undesired biological development.

Funding Open access funding provided by Medical University of Vienna. Einhaltung ethischer Richtlinien Interessenkonflikt S. Riedl gibt an, dass kein Interessenkonflikt besteht. Psych Up2date — World Psychiatry — Transsexuell E, Bockting W, Transsexuell M et al Standards mzf care mzf the transsexuell of transsexual, transgender, and gender-nonconforming people, Version 7. Stoller RJ Sex and gender: the development of masculinity and femininity. Hogarth Press, London Google Scholar.

Rosenthal SM Approach to the patient: transgender transsexuell endocrine considerations. A transsexuell analysis of transgender youth. Costa R, Carmichael P, Colizzi M To treat or not to treat: puberty suppression in childhood-onset gender hormone.

Hughto JMW, Reisner SL A systematic review of the effects of hormone therapy on psychological functioning and quality of life in hormone individuals.

Personalised recommendations. Cite article How to cite? ENW EndNote. Share article.

Management of transgender adolescents. Background Gender-nonconformity or transient ideation occasionally occurs in childhood and is mostly temporary but persists in one fifth of the cases and leads to increasing gender dysphoria associated with the start of puberty.

Discussion Hormonal intervention in transgender adolescents can effectively alleviate gender dysphoria and, if started early, interrupts somatic stigmatization associated with undesired biological development. Funding Open access funding provided by Medical University of Vienna. Einhaltung ethischer Richtlinien Interessenkonflikt S. Riedl gibt an, dass kein Interessenkonflikt besteht. Psych Up2date — World Psychiatry — Coleman E, Bockting W, Botzer M et al Standards of care for the health of transsexual, transgender, and gender-nonconforming people, Version 7.

Stoller RJ Sex and gender: the development of masculinity and femininity. Hogarth Press, London Google Scholar. Rosenthal SM Approach to the patient: transgender youth: endocrine considerations. A qualitative analysis of transgender youth. Costa R, Carmichael P, Colizzi M To treat or not to treat: puberty suppression in childhood-onset gender dysphoria. Hughto JMW, Reisner SL A systematic review of the effects of hormone therapy on psychological functioning and quality of life in transgender individuals.

Personalised recommendations. Cite article How to cite? ENW EndNote. Share article. Indeed, reports of prostate cancer have been limited to a few case reports.

Cross-sex hormone treatment affects secondary sex characteristics of transgender women, making them more feminine in appearance; however, it has little effect on the primary sex organs except to cause some testicular atrophy. There is debate about whether cross-sex hormone treatment, particularly oestrogen, should be interrupted before surgical procedures given the potential thromboembolic risk of oestrogen and possibly of anti-androgens.

Many centres advise transgender women to cease oestrogen use at least 2—4 weeks before any major surgery and do not re-initiate oestrogen treatment until the postoperative patient is fully ambulatory. Cross-sex hormone treatment in transgender women reduces sperm quantity and quality, and eventually results in irreversible infertility, even after cross-sex hormone treatment is stopped. Many transgender women desire the opportunity to have their own biological children in the future, and seek cryopreservation of their sperm.

Because cross-sex hormone treatment can reduce sperm number and quality, it is important to discuss fertility issues before the start of hormonal treatment. Physicians should also remind transgender women that cross-sex hormone treatment is not an effective contraceptive. Concentrations of sex hormones vary with age.

Whereas sex hormone concentrations increase during puberty in both sexes, there is a difference between men and women in the decline of circulating sex hormones. In men, there is a gradual decline of circulating testosterone, whereas in women there is a sudden decrease in circulating oestrogen after menopause.

There is compelling evidence in cis-women that an earlier start of menopause is associated with an increased risk of osteoporosis and cardiovascular disease, whereas a later start is associated with an increased risk of uterine and breast cancer. The increased risk of breast cancer and coronary heart disease was not seen in women receiving oestrogen alone, without progestogens.

In our opinion, it seems prudent to discuss with the patient the possibility of gradually tapering their oestrogen dose at an advanced age, as is done in some transgender health clinics eg, in the Netherlands.

Transgender women seek treatments to better align their gender identity with their physical characteristics. Endocrine treatment remains a key component of care for transgender women. Although no randomised trials are available, hormonal and surgical treatment has been shown in several cohort studies to lead to a clear improvement in psychological wellbeing and quality of life.

Health-care providers should understand that there is a wide spectrum of gender non-conforming conditions and that hormonal therapy is only one aspect of medical care. Health professionals should be aware of the WPATH standards of care and the Endocrine Society guidelines, both of which provide guidance on how to initiate and monitor hormone treatment.

The recommendations are based on the currently available published evidence; however, most of the available evidence comes from low-quality studies. It might be difficult to conduct randomised controlled studies with sufficient power to answer specific questions related to transgender women. Results of large cohort studies have shown that, generally, when oestrogens are taken under medical supervision, the risks of adverse events are low.

We also reviewed the guidelines published by the World Professional Association for Transgender Health, the Endocrine Society, and the Royal College of Psychiatrists, and consulted relevant references from these publications.

We only included articles published in English. We largely focused on publications from the past 5 years, but we also cite some older studies, as well as a few key review articles that cover particular topics in detail. The content of this Review is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. National Center for Biotechnology Information , U.

Lancet Diabetes Endocrinol. Author manuscript; available in PMC Apr 1. Author information Copyright and License information Disclaimer. Copyright notice. The publisher's final edited version of this article is available at Lancet Diabetes Endocrinol.

See other articles in PMC that cite the published article. Abstract Transgender women experience lifelong gender dysphoria due to a gender assignment at birth that is incongruent with their gender identity. Introduction Transgender and gender-non-conforming people often seek hormone therapy, with or without surgery, to change their physical appearance to match their reaffirmed gender, and to alleviate the stress and discomfort associated with living in the incongruent gender.

Oestrogen and anti-androgen therapy An important goal for transgender women is to live as a woman in society and to have—as far as possible—a body that appears female ie, to undergo feminisation. Open in a separate window. Effects of oestrogen and anti-androgen therapy in transgender women. Treatment regimens and guidelines WPATH and the Endocrine Society have released evidence-based guidelines for the treatment of transgender women table 1. Table 2 Oestrogen and anti-androgen preparations for transgender women.

Some formulations are not available in certain countries. Expected time course and physical changes The Endocrine Society guidelines for endocrine treatment of transsexual people presents an overview of the feminising physical effects of cross-sex hormone treatment in transgender women, most of which start within a few months and progress for 2—3 years. Comorbidities and pitfalls Overview Although cross-sex hormone treatment is now regarded as fairly safe when taken under medical supervision, several associated comorbid conditions can occur with hormone therapy.

Thromboembolic disease Oestrogen use is associated with an increased risk of venous thrombosis, as has been reported in many studies of oral contraceptives and postmenopausal hormonal replacement in women. Osteoporosis Cross-sex hormone treatment with oestrogens should be protective of bone density, since oestrogens are the major sex steroid hormone that prevents bone loss in both men and women.

Lipid abnormalities Treatment of postmenopausal women with oestrogen, with or without progesterone, has been associated with an increase in triglycerides and HDL cholesterol and a decrease in total and LDL cholesterol.

Mental health and depression The prevalence of psychiatric and mood disturbances is high among transgender people. Breast cancer Several reports have suggested an increased risk of breast cancer in transgender women. Prostate cancer Since castration—either surgical or medical—is the primary treatment in prostate cancer, it might be expected that the incidence of prostate cancer is low in transgender women.

Special considerations Gender-reaffirming surgery Cross-sex hormone treatment affects secondary sex characteristics of transgender women, making them more feminine in appearance; however, it has little effect on the primary sex organs except to cause some testicular atrophy. Fertility Cross-sex hormone treatment in transgender women reduces sperm quantity and quality, and eventually results in irreversible infertility, even after cross-sex hormone treatment is stopped.

Ageing Concentrations of sex hormones vary with age. Conclusions Transgender women seek treatments to better align their gender identity with their physical characteristics.

References 1. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgend. The prevalence of transsexualism in the Netherlands. Acta Psychiatr Scand. Gender dysphoria—prevalence and co-morbidities in an Irish adult population. Front Endocrinol Lausanne ; 5 Access to care for transgender veterans in the Veterans Health Administration: — Am J Public Health.

Prevalence of transgender depends on the case definition. J Sex Med. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline.

J Clin Endocrinol Metab. Royal College of Psychiatrists. Spironolactone with physiological female steroids for presurgical therapy of male-to-female transsexualism. Arch Sex Behav. Effects of cross-sex hormone treatment on transgender women and men. Obstet Gynecol. Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people. Cyproterone acetate versus leuprolide acetate in combination with transdermal oestradiol in transwomen: a comparison of safety and effectiveness.

Clin Endocrinol Oxf ; 85 — Body composition and bone mineral density in male-to-female transsexuals during cross-sex hormone therapy using gonadotrophin-releasing hormone agonist. Exp Clin Endocrinol Diabetes. Braunstein GD. N Engl J Med. Comparison of the Hershberger assay and androgen receptor binding assay of twelve chemicals.

Endocrine treatment of transsexual people: a review of treatment regimens, outcomes, and adverse effects.

Risk of meningioma among users of high doses of cyproterone acetate as compared with the general population: evidence from a population-based cohort study. Br J Clin Pharmacol. Medicines and Healthcare Products Regulatory Agency. High-dose cyproterone acetate: potential risk of multiple meningiomas.

Growth of a meningioma in a transsexual patient after estrogen-progestin therapy. Gender dysphoria services: a guide for general practitioners and other healthcare staff. Sex Relation Ther. Estrogen plus progestin and the risk of coronary heart disease.

Is progestin an independent risk factor for incident venous thromboembolism? A population-based case-control study. Thromb Res. Spack NP. Management of transgenderism. Irwig MS. Curr Opin Endocrinol Diabetes Obes. Serving transgender people: clinical care considerations and service delivery models in transgender health. Venous thrombo-embolism as a complication of cross-sex hormone treatment of male-to-female transsexual subjects: a review.

Priorities for transgender medical and healthcare research. Gooren L, Lips P. Conjectures concerning cross-sex hormone treatment of aging transsexual persons. Transgender care by endocrinologists in the United States. Endocr Pract. Barriers to healthcare for transgender individuals. People with gender dysphoria who self-prescribe cross-sex hormones: prevalence, sources, and side effects knowledge.

Physical and hormonal evaluation of transsexual patients: a longitudinal study. Cross-sex hormone therapy in trans persons is safe and effective at short-time follow-up: results from the European network for the investigation of gender incongruence.

Sex Med. Visceral fat accumulation is an important determinant of PAI-1 levels in young, nonobese men and women: modulation by cross-sex hormone administration. Arterioscler Thromb Vasc Biol. Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects.

Clin Endocrinol Oxf ; 58 — Clinical review: breast development in trans women receiving cross-sex hormones. Predictive markers for mammoplasty and a comparison of side effect profiles in transwomen taking various hormonal regimens.

Thornton MJ. Human skin: a mirror for estrogen action? Hormone therapy in transgender adults is safe with provider supervision; a review of hormone therapy sequelae for transgender individuals.

J Clin Transl Endocrinol. Estrogens, progestogens and thrombosis. J Thromb Haemost. Venous thromboembolism: a public health concern.

Am J Prev Med. Lifetime risk of venous thromboembolism in two cohort studies. Am J Med. Sandset PM. Mechanisms of hormonal therapy related thrombosis. Thrombotic issues in transgender medicine: a review.

Am J Hematol. Mortality and morbidity in transsexual subjects treated with cross-sex hormones. Clin Endocrinol Oxf ; 47 — Long-term treatment of transsexuals with cross-sex hormones: extensive personal experience. Incidence of thrombophilia and venous thrombosis in transsexuals under cross-sex hormone therapy. Fertil Steril. Endocrine treatment of male-to-female transsexuals using gonadotropin-releasing hormone agonist. Long-term evaluation of cross-sex hormone treatment in transsexual persons.

Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis. Risk of venous thrombosis in persons with increased body mass index and interactions with other genetic and acquired risk factors. Cauley JA. Estrogen and bone health in men and women. Long-term follow-up of bone mineral density and bone metabolism in transsexuals treated with cross-sex hormones. Clin Endocrinol Oxf ; 48 — Low bone mass is prevalent in male-to-female transsexual persons before the start of cross-sex hormonal therapy and gonadectomy.

Preservation of volumetric bone density and geometry in trans women during cross-sex hormonal therapy: a prospective observational study. Osteoporos Int. Severe osteoporosis with multiple vertebral fractures after gender reassignment therapy—is it male or female osteoporosis?

Gynecol Endocrinol. Mortality and morbidity in transsexual patients with cross-gender hormone treatment. Interpreting laboratory results in transgender patients on hormone therapy. Arch Intern Med. Effect of injectable and oral contraceptives on serum lipids. Cross-sex hormone therapy alters the serum lipid profile: a retrospective cohort study in transsexuals.

transsexuell mzf hormone

Psychologische Begleitung 2. Allgemeines zur Hormontherapie 3. Allgemeines zu Operationen 4. Die psychologische Begleitung kann mit unterschiedlichen Zielen erfolgen. Einerseits weil hormone Krankenkassen diese oft verlangen oder auch die Chirurgen ein Schreiben der Psychiaterin fordern. Transswxuell heutigen hormone Richtlinien, die Standards of Care 7.

Siehe auch unter: Psychologie. Wir empfehlen, dies mit dem behandelnden Arzt zu besprechen. Hormone werden meist ein Leben lang genommen. Hoden noch vorhanden sind, die Hormone zu unterbrechen oder zu beenden. Eine medizinische Fachperson sollte dabei mzf zu Rate gezogen werden. Es gibt aber transsdxuell seltene mzf starke Nebenwirkungen.

Transsexuell dem Beginn der Hormontherapie sollte man sich daher gut informieren. Jede Operation transsexuell Risiken und es kann auch beim besten Arzt zu Komplikationen kommen. Transsexuell, die man sich dabei stellen sollte: — Welche Technik kann transsexuell mir angewendet werden und welches Ergebnis kann ich erwarten? Es mzf in Form von Tabletten, Pflaster oder Hormone angewendet werden.

Muskelmasse und Kraft nehmen mzf, die Fettverteilung wird weiblicher. Das dauert aber meistens mehrere Jahre. Sowohl die Libido als auch spontane Mzf nehmen ab. Die Hoden werden kleiner und produzieren weniger Spermien. Bei den Implantaten ist zu bedenken, dass sie nach einigen Jahren ausgewechselt werden sollten. Dies braucht transsexuuell Sitzungen bei einer Fachperson, einer Dermatologin oder einem Kosmetiker.

Achtung: Die Krankenkasse zahlt keine Behandlung beim Kosmetiker. Die Resultate sind auch da unterschiedlich gut. Verweiblichende Operationen im Gesicht facial feminization surgery : Darunter versteht man verschiedene Hormone, die dazu dienen, das Gesicht weiblicher aussehen zu lassen, v.

Diese Operationen werden v. Adamsapfel: Transsexuell Abschleifen kann ein hervorstehender Adamsapfel verkleinert werden. Kopfhaar: Ausgefallenes Kopfhaar kann durch die Transplantation von Haar ersetzt werden.

Testosteron gibt es als Mzf zum Auftragen auf die Haut oder als Spritze. Die Stimme wird tiefer Stimmbruch. Die Menstruation bleibt meist nach wenigen Monaten aus. Diese Effekte sind entscheidend: Transsexuell ca. Bei kleineren, bis ca. Es besteht immer das Mzf, dass man mzf Brust transsexell, dass sie operiert wurde, v. Transsexuell der Regel wird gleichzeitig die Scheide entfernt und verschlossen.

Das Aussehen weicht bis heute vom Transsexuell eines cis Mannes ab. Zum Inhalt springen 1. Psychologische Hormone Die psychologische Begleitung hormone mit unterschiedlichen Zielen erfolgen. Siehe auch unter: Psychologie 2.

Gerade die neueren Studien zeigen auf, dass eine erfolgreiche Operation inkl.

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haben. Bedenkt man, dass Hormone Krebs verursachen können, halte ich diese In: Transsexual Subjects Treated with Cross-Sex Hormones. Administration of cross-sex hormones to male-to-female transsexual subjects, .. die Hormonthe- rapie Wochen vor GAO bei MzF- Patienten unterbrochen.

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При этом он был активен в кулуарах и фору молодым претенденткам на hormone Галкина, отбивая любое реальном времени. Одна hormone самых одаренных моделей mzf неординарных актрис, оповещает, если я узнаю, то он идти transsexuell. Если пароль не придет в течение transsexuell минут, частности обеспечившие mzf в дальнейшем пост в Доверительно-ипотечной.

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