Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline

被引：669

作者：

Hembree, Wylie C. ^{[1
,2
]}

Cohen-Kettenis, Peggy ^{[3
]}

Delemarre-van de Waal, Henriette A. ^{[3
,4
]}

Gooren, Louis J. ^{[5
]}

Meyer, Walter J., III ^{[6
]}

Spack, Norman P. ^{[7
]}

Tangpricha, Vin ^{[8
]}

Montori, Victor M. ^{[9
]}

机构：

[1] Columbia Univ, New York, NY 10032 USA

[2] New York Presbyterian Hosp, New York, NY 10032 USA

[3] Vrije Univ Amsterdam Med Ctr, NL-1007 MB Amsterdam, Netherlands

[4] Leiden Univ, Med Ctr, NL-2300 RC Leiden, Netherlands

[5] Andro Consult, Chaingmai 50220, Thailand

[6] Univ Texas Galveston, Med Branch, Galveston, TX 77555 USA

[7] Harvard Univ, Sch Med, Boston, MA 02115 USA

[8] Emory Univ, Sch Med, Atlanta, GA 30322 USA

[9] Mayo Clin, Rochester, MN 55905 USA

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2009年 / 94卷 / 09期

基金：

美国国家卫生研究院;

关键词：

MALE-TO-FEMALE; GENDER IDENTITY DISORDER; BONE-MINERAL DENSITY; HUMAN CHORIONIC-GONADOTROPIN; HORMONE-SECRETION PATTERNS; PLASMA TOTAL HOMOCYSTEINE; SEX REASSIGNMENT SURGERY; FOLLOW-UP; LUTEINIZING-HORMONE; BREAST-CANCER;

D O I：

10.1210/jc.2009-0345

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: The aim was to formulate practice guidelines for endocrine treatment of transsexual persons. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence, which was low or very low. Consensus Process: Committees and members of The Endocrine Society, European Society of Endocrinology, European Society for Paediatric Endocrinology, Lawson Wilkins Pediatric Endocrine Society, and World Professional Association for Transgender Health commented on preliminary drafts of these guidelines. Conclusions: Transsexual persons seeking to develop the physical characteristics of the desired gender require a safe, effective hormone regimen that will 1) suppress endogenous hormone secretion determined by the person's genetic/biologic sex and 2) maintain sex hormone levels within the normal range for the person's desired gender. A mental health professional (MHP) must recommend endocrine treatment and participate in ongoing care throughout the endocrine transition and decision for surgical sex reassignment. The endocrinologist must confirm the diagnostic criteria the MHP used to make these recommendations. Because a diagnosis of transsexualism in a prepubertal child cannot be made with certainty, we do not recommend endocrine treatment of prepubertal children. We recommend treating transsexual adolescents (Tanner stage 2) by suppressing puberty with GnRH analogues until age 16 years old, after which cross-sex hormones may be given. We suggest suppressing endogenous sex hormones, maintaining physiologic levels of gender-appropriate sex hormones and monitoring for known risks in adult transsexual persons. (J Clin Endocrinol Metab 94: 3132-3154, 2009)

引用

页码：3132 / 3154

页数：23

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