The Endocrine Society's clinical practice guideline on the endocrine treatment of gender-dysphoric/gender-incongruent persons provides detailed recommendations and suggestions for treating individuals with gender dysphoria/gender incongruence. The guideline is based on existing medical literature and clinical experience, aiming to maximize benefit and minimize risk. Key points include: 1. **Evaluation and Diagnosis**: - Only trained mental health professionals (MHPs) should diagnose gender dysphoria/gender incongruence in adults and children/adolescents. - Prepubertal youths with gender dysphoria/gender incongruence should be evaluated by an MHP or experienced professional. - Puberty blocking and gender-affirming hormone treatment are not recommended for prepubertal children. 2. **Treatment of Adolescents**: - Adolescents diagnosed with gender dysphoria/gender incongruence should initially undergo pubertal hormone suppression. - GnRH analogs can be used to suppress pubertal hormones. - Hormone treatment should be initiated after a multidisciplinary team confirms the persistence of gender dysphoria/gender incongruence and the individual has sufficient mental capacity to give informed consent. 3. **Hormonal Therapy for Adults**: - Clinicians should confirm the diagnostic criteria for gender dysphoria/gender incongruence and address any medical conditions that may be exacerbated by hormone depletion. - Hormone levels should be monitored to ensure suppression of endogenous sex steroids and maintenance of normal physiologic levels. - Education about the onset and time course of physical changes induced by hormone treatment is recommended. 4. **Adverse Outcome Prevention and Long-term Care**: - Regular clinical evaluations and laboratory monitoring are recommended to assess physical changes and potential adverse effects. - Bone density measurements and cardiovascular risk assessments are important for transgender individuals. 5. **Surgery for Sex Reassignment and Gender Confirmation**: - Gender-affirming surgery should only be pursued after a multidisciplinary team confirms medical necessity and benefits. - Hormone treatment should be completed for at least one year before considering surgery. - Collaborative efforts between the treating clinician and the surgeon are essential. The guideline emphasizes the importance of multidisciplinary care, including mental health professionals, and the need for ongoing monitoring and follow-up. It also highlights the importance of shared decision-making and the potential risks and benefits of hormone and surgical treatments.The Endocrine Society's clinical practice guideline on the endocrine treatment of gender-dysphoric/gender-incongruent persons provides detailed recommendations and suggestions for treating individuals with gender dysphoria/gender incongruence. The guideline is based on existing medical literature and clinical experience, aiming to maximize benefit and minimize risk. Key points include: 1. **Evaluation and Diagnosis**: - Only trained mental health professionals (MHPs) should diagnose gender dysphoria/gender incongruence in adults and children/adolescents. - Prepubertal youths with gender dysphoria/gender incongruence should be evaluated by an MHP or experienced professional. - Puberty blocking and gender-affirming hormone treatment are not recommended for prepubertal children. 2. **Treatment of Adolescents**: - Adolescents diagnosed with gender dysphoria/gender incongruence should initially undergo pubertal hormone suppression. - GnRH analogs can be used to suppress pubertal hormones. - Hormone treatment should be initiated after a multidisciplinary team confirms the persistence of gender dysphoria/gender incongruence and the individual has sufficient mental capacity to give informed consent. 3. **Hormonal Therapy for Adults**: - Clinicians should confirm the diagnostic criteria for gender dysphoria/gender incongruence and address any medical conditions that may be exacerbated by hormone depletion. - Hormone levels should be monitored to ensure suppression of endogenous sex steroids and maintenance of normal physiologic levels. - Education about the onset and time course of physical changes induced by hormone treatment is recommended. 4. **Adverse Outcome Prevention and Long-term Care**: - Regular clinical evaluations and laboratory monitoring are recommended to assess physical changes and potential adverse effects. - Bone density measurements and cardiovascular risk assessments are important for transgender individuals. 5. **Surgery for Sex Reassignment and Gender Confirmation**: - Gender-affirming surgery should only be pursued after a multidisciplinary team confirms medical necessity and benefits. - Hormone treatment should be completed for at least one year before considering surgery. - Collaborative efforts between the treating clinician and the surgeon are essential. The guideline emphasizes the importance of multidisciplinary care, including mental health professionals, and the need for ongoing monitoring and follow-up. It also highlights the importance of shared decision-making and the potential risks and benefits of hormone and surgical treatments.