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Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder.
The World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a professional organization devoted to the understanding and treatment of gender identity and gender dysphoria, and creating standardized treatment for transgender and gender variant people. WPATH was founded in 1979 and named HBIGDA in honor of Harry Benjamin during a period where there was no clinical consensus on how and when to provide gender-affirming care. WPATH is mostly known for the Standards of Care for the Health of Transgender and Gender Diverse People (SOC).
The Standards of Care for the Health of Transgender and Gender Diverse People (SOC) is an international clinical protocol by the World Professional Association for Transgender Health (WPATH) outlining the recommended assessment and treatment for transgender and gender-diverse individuals across the lifespan including social, hormonal, or surgical transition. It often influences clinicians' decisions regarding patients' treatment. While other standards, protocols, and guidelines exist – especially outside the United States – the WPATH SOC is the most widespread protocol used by professionals working with transgender or gender-variant people.
A trans man is a man who was assigned female at birth. Trans men have a male gender identity, and many trans men undergo medical and social transition to alter their appearance in a way that aligns with their gender identity or alleviates gender dysphoria.
Gender transition is the process of affirming and expressing one's internal sense of gender, rather than the gender assigned to them at birth. It is the recommended course of treatment for individuals struggling with gender dysphoria, providing improved mental health outcomes in the majority of people.
Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.
Sexuality in transgender individuals encompasses all the issues of sexuality of other groups, including establishing a sexual identity, learning to deal with one's sexual needs, and finding a partner, but may be complicated by issues of gender dysphoria, side effects of surgery, physiological and emotional effects of hormone replacement therapy, psychological aspects of expressing sexuality after medical transition, or social aspects of expressing their gender.
Feminizing hormone therapy, also known as transfeminine hormone therapy, is hormone therapy and sex reassignment therapy to change the secondary sex characteristics of transgender people from masculine or androgynous to feminine. It is a common type of transgender hormone therapy and is used to treat transgender women and non-binary transfeminine individuals. Some, in particular intersex people, but also some non-transgender people, take this form of therapy according to their personal needs and preferences.
Various issues in medicine relate to lesbian, gay, bisexual, and transgender people. According to the US Gay and Lesbian Medical Association (GLMA), besides HIV/AIDS, issues related to LGBT health include breast and cervical cancer, hepatitis, mental health, substance use disorders, alcohol use, tobacco use, depression, access to care for transgender persons, issues surrounding marriage and family recognition, conversion therapy, refusal clause legislation, and laws that are intended to "immunize health care professionals from liability for discriminating against persons of whom they disapprove."
A transsexual person is someone who experiences a gender identity that is inconsistent with their assigned sex, and desires to permanently transition to the sex or gender with which they identify, usually seeking medical assistance to help them align their body with their identified sex or gender.
Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, they face different challenges compared to adults. According to the World Professional Association for Transgender Health, the American Psychological Association, and the American Academy of Pediatrics, appropriate care for transgender youth may include supportive mental health care, social transition, and/or puberty blockers, which delay puberty and the development of secondary sex characteristics to allow children more time to explore their gender identity.
Transgender women are women who were assigned male at birth. Trans women have a female gender identity and may experience gender dysphoria. Gender dysphoria may be treated with gender-affirming care.
Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens and estrogens. Puberty blockers are used to delay puberty in children with precocious puberty. They are also used to delay the development of unwanted secondary sex characteristics in transgender children, so as to allow transgender youth more time to explore their gender identity. The same drugs are also used in fertility medicine and to treat some hormone-sensitive cancers in adults.
Gender-affirming hormone therapy (GAHT), also called hormone replacement therapy (HRT) or transgender hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:
The real-life experience (RLE), sometimes called the real-life test (RLT), is a period of time or process in which transgender individuals live full-time in their identified gender role in order to be eligible to receive gender-affirming treatment. The purpose of the RLE has been to confirm that a given transgender person could function successfully as a member of said gender in society, as well as to confirm that they are sure they want to live as said gender for the rest of their life. A documented RLE was previously a requirement of many physicians before prescribing gender-affirming hormone therapy, and a requirement of most surgeons before performing gender-affirming surgery.
Transgender pregnancy is the gestation of one or more embryos or fetuses by transgender people. As of 2024, the possibility is restricted to those born with female reproductive systems. However, transition-related treatments may impact fertility. Transgender men and nonbinary people who are or wish to become pregnant face social, medical, legal, and psychological concerns. As uterus transplantations are currently experimental, and none have successfully been performed on trans women, they cannot become pregnant.
Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world. Gender affirming health care can include psychological, medical, physical, and social behavioral care. The purpose of gender affirming care is to help a transgender individual conform to their desired gender identity.
Detransition is the cessation or reversal of a transgender identification or of gender transition, temporarily or permanently, through social, legal, and/or medical means. The term is distinct from the concept of 'regret', and the decision may be based on a shift in gender identity, or other reasons, such as health concerns, social or economic pressure, discrimination, stigma, political beliefs, or religious beliefs.
The Study of Transition, Outcomes, and Gender (STRONG) is a cohort study of health in transgender people before and during or after gender-affirming treatments such as gender-affirming hormone therapy and gender-affirming surgery. It is being conducted at Kaiser Permanente sites in Northern California, Southern California, and Georgia and includes over 6,000 transgender people. The study was underway by 2015 and the first paper for the study was published in 2017. The STRONG cohort represents the largest cohort of transgender people studied to date and the first such large-scale study conducted in the United States.
Ada Cheung is an Australian clinical scientist, endocrinologist and researcher who is known for her research in transgender studies.
References
- 1 2 3 4 5 Kennedy, Caitlin E.; Yeh, Ping Teresa; Byrne, Jack; van der Merwe, L. Leigh Ann; Ferguson, Laura; Poteat, Tonia; Narasimhan, Manjulaa (2022). "Self-administration of gender-affirming hormones: a systematic review of effectiveness, cost, and values and preferences of end-users and health workers". Sexual and Reproductive Health Matters. 29 (3): 2045066. doi:10.1080/26410397.2022.2045066. ISSN 2641-0397. PMC 8942532 . PMID 35312467.
- ↑ Edenfield, Avery C.; Holmes, Steve; Colton, Jared S. (3 July 2019). "Queering Tactical Technical Communication: DIY HRT". Technical Communication Quarterly. 28 (3): 177–191. doi:10.1080/10572252.2019.1607906. S2CID 151159278.
- 1 2 Deutsch, Madeline B. (June 2016). "Evaluation of Patient-Oriented, Internet-Based Information on Gender-Affirming Hormone Treatments". LGBT Health. 3 (3): 200–207. doi:10.1089/lgbt.2015.0116. PMID 26829020.
- 1 2 Edenfield, Avery C. (January 2021). "Managing Gender Care in Precarity: Trans Communities Respond to COVID-19". Journal of Business and Technical Communication. 35 (1): 15–21. doi: 10.1177/1050651920958504 .
- ↑ Rotondi, Nooshin Khobzi; Bauer, Greta R.; Scanlon, Kyle; Kaay, Matthias; Travers, Robb; Travers, Anna (October 2013). "Nonprescribed Hormone Use and Self-Performed Surgeries: "Do-It-Yourself" Transitions in Transgender Communities in Ontario, Canada". American Journal of Public Health. 103 (10): 1830–1836. doi:10.2105/AJPH.2013.301348. PMC 3780733 . PMID 23948009.
- ↑ Wexler, Abba (2022). "Mapping the Landscape of Do-it-Yourself Medicine". Citizen Science: Theory and Practice. 7 (1): 38. doi: 10.5334/cstp.553 . ISSN 2057-4991. PMC 9830450 . PMID 36632334.
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