Hormone treatment in gender dysphoria

In Italy hormonal treatment for persons with Gender Identity Dysphoria can be prescribed by endocrinologists only after a well-defined diagnosis has been formulated by trained psychologists/psychiatrists. Prescriptions must be preceded by exclusion of major comorbidities, which could physically and psychologically interfere with the sex reassignment procedure. Real life test is finalized to improve the psychosocial functioning according to the desired sex and allows also to confirm the diagnosis. For males who want to become women, treatment consists of estrogens and antiandrogens. For females who want to become men, treatment is most commonly composed of esters of testosterone. Venous thromboembolism, the most frequent complication in the past years, is nowadays far less frequent. The endocrinological follow-up is necessary, as postsurgical hypogonadism must be treated with chronic replacement therapy. (C) 2008 Elsevier Masson SAS. All rights reserved.