From the Guidelines
Transgender identity is not caused by insufficient hormones or hormone receptor issues. The current understanding of transgender medicine, as outlined in the revised Endocrine Society 2017 treatment guidelines 1, emphasizes that transgender individuals should receive safe and effective hormone regimens targeting typical hormone ranges associated with their gender identities, but this is not a treatment for a hormonal disorder. According to the Annual Review of Medicine 1, being transgender is a complex aspect of human diversity related to gender identity, which is a person's internal sense of their own gender.
Some key points to consider include:
- The term "transgender" is an umbrella term used to categorize individuals whose gender identity does not match the sex recorded on their original birth certificate 1.
- Gender identity development involves a complex interplay of genetic, neurobiological, psychological, and social factors, and there is no single "cause" of transgender identity that has been identified 1.
- Some transgender individuals may choose to undergo hormone therapy as part of their transition to help align their physical characteristics with their gender identity, but this is a treatment option for those who experience gender dysphoria, not a cause of being transgender 1.
- The use of gender dysphoria by the World Health Organization’s International Classification of Diseases (ICD) for the diagnosis of transgender individuals has resulted in the practice of healthcare providers and companies using the term for billing and reimbursement for medical interventions, but expressions of gender identity are not a mental health condition per se 1.
Overall, the scientific understanding suggests that transgender identity is a natural part of human diversity, and hormone therapy is a treatment option for those who experience gender dysphoria, not a cause of being transgender.
From the Research
Hormonal Influence on Transgenderism
- The relationship between hormones and transgenderism is complex, with some studies suggesting that hormonal treatments can be effective in alleviating gender dysphoria 2, 3.
- However, other studies argue that hormonal treatments may not address the underlying psychological issues and can cause irreversible bodily harm 4.
- The use of exogenous hormones, such as estrogen and testosterone, can have significant effects on the body, including changes in hemostatic parameters and increased risk of thrombosis 5.
Hormone Receptor Issues
- There is limited research on the specific role of hormone receptor issues in transgenderism, but some studies suggest that anatomic brain differences and certain parental factors may be associated with transsexualism 6.
- The Endocrine Society's clinical practice guideline recommends that clinicians be knowledgeable about the diagnostic criteria and criteria for gender-affirming treatment, and have sufficient training and experience in assessing psychopathology 3.
Insufficient Hormones
- Some studies suggest that insufficient hormones or hormone imbalances may contribute to gender dysphoria, but the evidence is not conclusive 2, 3.
- The use of hormone therapy, such as gonadotropin-releasing hormone agonists, can be effective in suppressing endogenous sex hormone secretion and maintaining sex hormone levels within the normal range for the person's affirmed gender 3.