Difference between revisions of "Hormone therapy"

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'''Hormone therapy''' involves blocking the body's sex hormones and/or replacing or supplementing these with a different sex hormone or set of sex hormones. Sex hormones include estrogen (aka oestrogen), progesterone and testosterone. Blockers include antigonadotropins such as danazol.
 
Some people opt not to combine hormone therapy with the equivalent binary social transition, or to socially transition in order to access hormone therapy from [[gatekeeper|medical gatekeepers]], then later 'de-transition' or 're-transition' to their preferred social role or presentation. This may also occur as an unplanned consequence of following whichever aspects of [[transition]] best minimize both social and physical [[gender dysphoria]].
 
== Puberty blockers ==
 
''See main article: [[puberty blockers]].''
 
Puberty blockers are drugs that postpone or temporarily suspend puberty in children and teenagers. They are used for [[transgender]] children, including those who identify as [[nonbinary]], to stop the development of features that they consider to mark the wrong sex,<ref name=":0">{{Cite journal|last=Stevens|first=Jaime|last2=Gomez-Lobo|first2=Veronica|last3=Pine-Twaddell|first3=Elyse|date=2015-12-01|title=Insurance Coverage of Puberty Blocker Therapies for Transgender Youth|url=http://pediatrics.aappublications.org/content/136/6/1029|journal=Pediatrics|language=en|volume=136|issue=6|pages=1029–1031|doi=10.1542/peds.2015-2849|issn=0031-4005|pmid=26527547|doi-access=free}}</ref><ref>{{cite web |url=http://www.washingtontimes.com/news/2016/mar/12/looking-at-suppressing-puberty-for-transgender-kid/ |title=Looking at suppressing puberty for transgender kids |publisher=Associated Press |date=March 12, 2016}}</ref><ref>{{cite web |url=https://ww2.kqed.org/futureofyou/2016/08/19/transgender-youth-using-puberty-blockers/ |title=Transgender Youth Using Puberty Blockers |publisher=[[KQED]] |date=August 19, 2016}}</ref> with the intent to provide transgender youth more time to explore their identity.<ref name=":1">{{Cite journal|last=Alegría|first=Christine Aramburu|date=2016-10-01|title=Gender nonconforming and transgender children/youth: Family, community, and implications for practice|journal=Journal of the American Association of Nurse Practitioners|language=en|volume=28|issue=10|pages=521–527|doi= 10.1002/2327-6924.12363|pmid=27031444|issn=2327-6924}}</ref> the studies that have been conducted indicate that these treatments are reasonably safe, and can improve psychological well-being in these individuals.<ref name="lancet_pubertyblockers">{{cite journal | last=Mahfouda | first=Simone | last2=Moore | first2=Julia K | last3=Siafarikas | first3=Aris | last4=Zepf | first4=Florian D | last5=Lin | first5=Ashleigh | title=Puberty suppression in transgender children and adolescents | journal=The Lancet Diabetes & Endocrinology | publisher=Elsevier BV | volume=5 | issue=10 | year=2017 | issn=2213-8587 | doi=10.1016/s2213-8587(17)30099-2 | pmid=28546095 | pages=816–826 | ref=harv|quote=The few studies that have examined the psychological effects of suppressing puberty, as the first stage before possible future commencement of CSH therapy, have shown benefits."}}</ref><ref>{{cite journal |last1=Rafferty |first1=Jason |title=Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents |journal=Pediatrics |date=October 2018 |volume=142 |issue=4 |pages=e20182162 |url=https://pediatrics.aappublications.org/content/142/4/e20182162 |accessdate=23 July 2019|quote=Often, pubertal suppression...reduces the need for later surgery because physical changes that are otherwise irreversible (protrusion of the Adam’s apple, male pattern baldness, voice change, breast growth, etc) are prevented. The available data reveal that pubertal suppression in children who identify as TGD generally leads to improved psychological functioning in adolescence and young adulthood.|doi=10.1542/peds.2018-2162 |pmid=30224363 |doi-access=free }}</ref><ref name="Hembree_et_al">{{cite journal |last1=Hembree |first1=Wylie C |last2=Cohen-Kettenis |first2=Peggy T |last3=Gooren |first3=Louis |last4=Hannema |first4=Sabine E |last5=Meyer |first5=Walter J |last6=Murad |first6=M Hassan |last7=Rosenthal |first7=Stephen M |last8=Safer |first8=Joshua D |last9=Tangpricha |first9=Vin |last10=T'Sjoen |first10=Guy G |title=Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline |journal=The Journal of Clinical Endocrinology & Metabolism |date=November 2017 |volume=102 |issue=11 |page=3881|quote=Treating GD/gender-incongruent adolescents entering puberty with GnRH analogs has been shown to improve psychological functioning in several domains|doi=10.1210/jc.2017-01658 |pmid=28945902 |doi-access=free }}</ref> In 2019, a study in the journal ''Pediatrics'' found that access to pubertal suppression during adolescence was associated with a lower odds of lifetime suicidality among transgender people.<ref>{{cite journal |last1=Turban |first1=Jack |title=Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation |journal=Pediatrics |date=February 2020 |volume=145 |issue=2 |page=e2019172 |doi=10.1542/peds.2019-1725 |pmid=31974216 |url=https://pediatrics.aappublications.org/content/145/2/e20191725 |accessdate=11 February 2020|pmc=7073269 }}</ref>
 
== Transfeminine hormone therapy ==
* GnRH agonists: also known as "puberty blockers" within the transgender community, they are not recommended as a long-term solution, as they cause poor bone health.
 
Methods for permanently stopping menstrual bleeding which are not a form of hormone therapy include [[uterine ablation]], in which the inside of the uterus is cauterized to prevent it from developing or shedding uterine lining, and [[hysterectomy]], the surgical removal of the uterus. Neither of these necessarily prevent other symptoms of menstrual cycles, such as mood swings during premenstruation.
Alternatively to hormone therapy, [[hysterectomy]] is the surgical removal of the uterus and is the definitive (and irreversible) option.
 
==See also==
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