Talk:Gender-affirming hormone therapy/Archive 1

Archive 1

Expansion ideas

Risks, forms of transition, types of medicine, specific procedures, etc - Unregistered Editor Lord0Trade. Thursday June 23, 2016, 4:48 PM — Preceding unsigned comment added by 2601:446:101:59D0:436:876E:2DC:259B (talk) 21:47, 23 June 2016 (UTC)

WPATH consent only

Isn't the current WPATH standard a consent-only model? That is literally how I received my HRT (In the USA) as of late 2016. — Preceding unsigned comment added by Electrocutie (talk • contribs) 00:45, 3 February 2017 (UTC)

1. @Electrocutie: No, there are other standards Hombre de Vitruvio (talk) 01:57, 3 February 2017 (UTC)

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Body weight, body fat, lean body mass

A meta-analysis was published about the effects of cross-sex HRT on body weight, body fat, and lean body mass: Klaver 2017, Cross-sex hormone therapy in transgender persons affects total body weight, body fat and lean body mass: a meta-analysis. doi:10.1111/and.12660. Maybe someone who has some medical knowledge can use it to the improve the articles. --Gorlingor (talk) 04:53, 8 June 2017 (UTC)

I think the article would benefit from citing non-medical sources (ie, the experiences of transgender people with HRT)

Anecdotes are not by themselves reliable sources, of course, but there are extensive secondary writings online by trans people discussing the subjective effects of HRT and its social aspects. It's a medical treatment, but its result is a psychologically and socially complex phenomenon that many people describe in spiritual, cultural, or political terms. I don't feel qualified to do this editing myself since I have no specialist knowledge beyond being trans myself, but it's in desperate need of doing. ❃Adelaide❃ (talk) 22:43, 13 December 2017 (UTC)

Outdated - needs a rewrite

I've tagged this article as update needed, as the information it presents is significanty outdated. The WPATH SoC v7 no longer mandate a real-life experience (RLE) or psychotherapy prior to recommendation of HRT, and are therefore compatible with and similar to the informed consent model. This is a significant departure from the previous SoC on which this article is based. Similarly, the DSM V has replaced the diagnosis of GID with gender dysphoria, and the diagnostic criteria are significantly different.

I'm happy to work on this if I have time, but otherwise someone could jump in and update it based on the latest guidelines. The SoC v7 is freely available from the WPATH website. 2001:44B8:3149:7900:84E2:5A:1949:92E4 (talk) 13:58, 7 February 2017 (UTC)

I've updated it for SOC v7. Kaldari (talk) 08:10, 8 March 2019 (UTC)

Gender-Affirming vs. Hormone Replacement

The term "gender-affirming hormone therapy" is more precise than "hormone replacement therapy" and is preferred. I propose to change this terminology in the opening sentence, and that all subsequent references to "HRT" be changed to "GAHT". Here are a few references for this terminology: <http://www.transhealth.ucsf.edu/trans?page=guidelines-overview><https://pediatrics.aappublications.org/content/141/4/e20173742> -WHNP (talk) 19:51, 22 July 2019 (UTC)

Are you proposing "gender-affirming hormone therapy" rather than "transgender hormone therapy"? Doc James (talk · contribs · email) 03:52, 23 July 2019 (UTC)

No, I was proposing changing the mentions of "hormone replacement therapy" to "gender-affirming hormone therapy" -WHNP (talk) 14:38, 24 July 2019 (UTC)

I'm thinking we don't need the Transgender hormone therapy article. We already have the Sex reassignment therapy and Sex reassignment surgery articles. "Gender-affirmation therapy" is an alternative (less common) title for sex reassignment therapy. See WP:Common name. And we already have an article on that. The Transgender hormone therapy article should simply redirect to the "Sex reassignment therapy" article. I'll do that after waiting a day or two for more replies in this section. Flyer22 Reborn (talk) 15:53, 23 July 2019 (UTC)

I believe "hormone replacement therapy" article deserves it's own article page. The Sex reassignment therapy article has a good overview, and HRT pharmacology is more complex than what's listed. If anything, there should be a redirection between these two articles. I plan to create a more thorough medical article integrated with cultural publications.Rxbpherrera (talk) 21:41, 29 July 2019 (UTC)

Rxbpherrera, I still don't think it should be its own article. There is nothing that can go in this article that can't and shouldn't be covered in the Sex reassignment therapy article. And there is no need for excessive detail. But I'll wait and see what you and your class come up with. For the medical material, try to stick to sourcing that passes WP:MEDRS. Also stick to WP:Due weight. And also make sure that the article is free of WP:Tone issues. See WP:Content forking as well. Flyer22 Reborn (talk) 20:28, 30 July 2019 (UTC) Flyer22 Reborn (talk) 20:46, 30 July 2019 (UTC)

Pinging Doc James so that he is aware of my decision to take a "wait and see" approach. Flyer22 Reborn (talk) 20:39, 30 July 2019 (UTC)

Foundations 2 2019, Group 6 b goals

1) clarify and update with correct terminology (hormone replacement therapy vs gender affirming hormone therapy) 2) Add HRT pharmacology section including therapeutic options with risks, benefit, goals and monitoring 3) Add section on clinical outcomes following hormone therapy 4) expand eligibility section with current guidelines

Allydiiorio (talk) 20:16, 30 July 2019 (UTC)

Allydiiorio, "hormone replacement therapy" is mainly discussed in the context of menopause. That is why the Hormone replacement therapy article is about menopause. As for "transgender hormone therapy" vs. "gender affirming hormone therapy," what WP:Reliable sources do you have on that? If the article is going to be titled "Transgender hormone therapy," then the lead sentence should begin with that title. If you are looking to move this article, then do start a WP:Requested moves discussion and make your case with WP:MEDRS-compliant sources. Otherwise, the article will be moved back. Flyer22 Reborn (talk) 20:39, 30 July 2019 (UTC)

Updated Goals Foundations Group 6 b

1)Expand upon diagnostic process and Society guidelines 2) Add small section overviewing treatment options for both male-to-female and female-to-male treatments (more in depth in other articles) 3) Add section describing psychosocial impact and mental health 4) Add section describing monitoring and goals before/during/after treatment

Allydiiorio (talk) 21:53, 2 August 2019 (UTC)

Sabrina's peer review (Group 6A)

1. A) Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”? The lead section is easy to understand and gives a good summary to readers. There was no edits made there. There is a clear structure under treatment options that specifies the two types of therapy for feminizing and masculinizing along with an overall guideline. The two types of therapy were covered which shows balanced coverage, and there is multiple sources (Mayo Clinic, meta analyses, guidelines) used as data information. The content is neutral and based on guidelines, and the sources are derived from reliable clinics such as mayo clinic.

B) Has the group achieved its overall goals for improvement? The group did not update terminology to reflect "gender affirming hormone therapy". There was an added treatment section with pharmacologic treatment; however, side effects were not listed other than fertility issues of gender affirming hormone therapy. There was not a section on clinical outcomes following hormone therapy. There was an expansion of treatment eligibility regarding psychiatric conditions.

2. Is there any evidence of plagiarism or copyright violation? If yes, specify. The information that is derived from guidelines mimics the guidelines. The rest of the information such as in the Fertility Consideration section is not plagiarized.

Sabrinabulla (talk) 21:51, 5 August 2019 (UTC)

Nora's Peer Review (Group 6a)

1. a. Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”? The lead section is easy to understand. It defines transgender hormone therapy and other terms that it may also be called. It also appropriately defines feminizing hormone therapy and masculinizing hormone therapy. The various terms are hyperlinked which makes it easy for the reader to easily obtain definitions. The structure is clear and the tone remains neutral. The subsections under “Treatment Options” make the article easy to follow. Perhaps more information could be added under “Safety” as there is only one sentence and it is usually major concern when starting a new treatment.

b. Has the group achieved its overall goals for improvement? The group added more information on feminizing hormone therapy and masculinizing hormone therapy, which is effectively provides a summary of treatment. The section under “Masculinizing hormone therapy” could be expanded further to specify exactly when and how testosterone is administered. The information is gathered from guidelines and the Mayo Clinic which is practical and up-to-date.

2. Person C. Are the edits formatted consistent with Wikipedia’s manual of style? If not, specify… The edits are consistent with Wikipedia’s style. They are written in a neutral tone and are applicable information. The information is gathered from guidelines and the Mayo Clinic which makes it directly applicable to the audience. The group could consider removing the “Fertility Consideration” subsection and combining that information with “Safety.”

NoraCortez (talk) 06:49, 6 August 2019 (UTC)

UCSF Foundations 2 2019, Group 6a: Kim Chi's Peer Review

1a: Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”?

• The lead includes importance of subject and there is a clear structure; structures are well-organized and flow is easy to read (starting off with "Treatment Guidelines" leading into types of treatments and then safety considerations). All topics are necessary and important to the overall subject.

1b: Has the group achieved its overall goals for improvement?

• Goals were to improve treatment guidelines in addition to providing more information about available treatments for various types of gender identities, which were met with the edits that were added to the article.

2a: Does the draft submission reflect a neutral point of view? If not, specify…

• Draft submission has a neutral point of view.

Knguyen525 (talk) 16:54, 6 August 2019 (UTC)

Amanda's Peer Review - Group 6a

1a. Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”? The leading section was not edited, however it is clear and concise. The sections of the article are fairly well organized, but I think the fertility section could be included underneath the safety heading. The article is well balanced although I think there could be more content on the safety of transgender hormone therapy. The article is neutral and doesn't use any commentary to suggest that the author is taking sides. There are reliable sources used to provide evidence for the material added.

1b. Has the group achieved its overall goals for improvement? The group did a good job of meeting their goals although some of them could be described in more depth, such as the psychosocial impact and mental health. There could also be more detail on the monitoring after therapy is initiated.

2. Are the points included verifiable with cited secondary sources that are freely available? If not, specify… The points added into the article are obtained from sources that are readily available for readers and they are all up-to-date (published within the last 5 years and secondary literature).

Amandabair (talk) 17:10, 6 August 2019 (UTC)

Peer Review

I utilized Wikipedia's Peer Review template, which breaks peer review down into these categories:

Lead

• The term 'gender-affirming hormone therapy' replaced the less specific and outdated 'hormone therapy' that existed in the previous edition of the article.
• The Lead portion of this article is concise and not overly detailed, as recommended by Wikipedia.
• The use of gender-affirming hormone therapy in the context of intersex individuals is helpful to keep in this Lead portion, because it offers readers another common indication for hormone therapy, aside from gender dysphoria.
• Suggestion: in your Workplan, you mention expanding on the different definitions of gender identity here. Do you still plan on commenting on this in the Lead section or did you decide against it?

Content

• Requirements section
  • It is helpful that geographic and institution-specific differences are highlighted, as well as the different medical subspecialties that prescribe gender affirming therapies. Maybe readers would find it helpful to read about these specialties through a hyperlink. You could link these three specialties to their respective Wikipedia pages by highlighting them and clicking the chain to the left of the Cite button.
  • The third paragraph is much more clear to me after the edits that it underwent, with the International Journal of Transgenderism SOC. It paints a clear picture that either a mental health professional OR a hormone provider specialized in transgender care can evaluate a patient for gender dysphoria. It also comments well on the SOC's recommendation of controlling comorbidities prior to initiating gender-affirming hormone therapy.
  • The final sentence of the Requirements section above Gender dysphoria refers to the two approaches, I believe: requiring a therapist's sign off and the informed consent model. Do I have that correct?
  • Gender dysphoria subsection:
    • This content was added and is a welcomed addition to the flow of this section.
    • It includes a definition of gender dysphoria, its prerequisite relation to gender-affirming therapy, as well as common comorbidities seen with it.
• Treatment options section
  • To me, it seems very important that global readers make sense of the variance in these treatment options, as they
  • Delaying puberty in adolescents subsection:
    • This entire subsection was added based on evolving treatment paradigms in this space. WPATH recommendations make up most of this section, and given their recommendations, it is important to have this subsection here.
    • Seeing as WPATH emphasizes puberty-suppressing hormone therapy as reversible, this treatment option contrasts nicely with the others, which are more permanent.
  • Feminizing hormone therapy subsection:
    • The addition of various routes of estrogen therapy, with a citation, flows well here given that the same was previously done for testosterone in masculinizing therapy (oral, IM, subcutaneous injections, etc.).
    • I like how the author elaborated on what desired secondary female sex characteristics are. in the second to last paragraph here. It saves the reader from having to enter another article to seek out an understanding of those.
    • Only question I have, largely due to my ignorance, is are 'female' and 'feminine' used interchangeably in the context of secondary sex characteristics? I notice the same with 'masculine' in the next section.
  • Masculinizing hormone therapy subsection:
    • Citation 11 adds an interesting caveat to masculinizing hormone therapy. Neat that this detail about inhibiting estrogen was added.
    • The addition of the final paragraph, where masculine secondary sex characteristics are added provides nice balance to the feminizing hormone therapy subsection, which mentions the same of feminine secondary sex characteristics.
• Safety section:
  • Charts of the SOC summary of risks of both feminizing and masculinizing hormone therapy are welcomed additions to this portion of the article, as well as to the article in general.
  • Under Masculinizing hormone therapy, do you mean to title the chart "Summary of Risks of Testosterone Therapy"?
  • Awesome charts!

Tone and Balance

• My opinion is that the article has an objective flow and tone to it. Never once reading it did I feel as if any of the cumulative authors were trying to sway the reader in any particular direction.
• Relying on guidelines and recommendations, as opposed to primary research studies, aids in the objective feel to this article.
• The recent additions to the article provide strong accompanying details to what was already there, just with more recent updates. This is challenging to do in a topic that is as rapidly evolving as Transgender hormone therapy.

Sources and Resources

• As mentioned, I like how this article focuses on guidelines from trusted sources in the realm of transgender patient care, as opposed to primary research articles. Many of these sources come from the World Professional Association for Transgender Health.
• The citations that were added backed up the claims that were clarified in the article, without copying them word for word.

Organization

• The overall architecture of this article is well thought out. The added subsections were improvements to the organization of the article, in my view.
• The five main sections as it stands right now are: Requirements, Treatment options, Safety, Treatment eligibility, and Accessibility. I will be curious to see how this evolves over the future.

Images and Media

• As mentioned, I like the inclusion of the charts from the SOC citation. Nothing keeps the attention of someone reading a block of text better than a figure or chart!

Overall impressions

• My observation in this peer review is that the article has undergone fruitful changes. These changes include updated guidelines and recommendations on definitions and terminology ("gender-affirming hormone therapy", addition of gender dysphoria paragraph, medical subspecialties qualified for care of transgender patients, etc.), the mechanism and risks of both feminizing and masculinizing hormone therapy, and the addition of a paragraph on a previously unmentioned treatment strategy: delaying puberty in adolescents.
• It is my understanding that these updates and changes are in accordance with guidelines from the World Professional Association for Transgender Health and other trusted sources.
• I have included a few suggestions in the write-up above where I felt like this article could have benefitted slightly more, but please take these as constructive critiques!
  

Amcclanahan (talk) 21:48, 16 November 2021 (UTC)

WikiProject Medicine: Work Plan

Hello Wikipedians --

My name is Kevin. I am a fourth-year medical student pursuing a career in Obstetrics & Gynecology. Additionally, I completed a Master of Public Health degree focusing on Women, Gender, and Health. My primary research focus is Transgender Medicine. I am editing this page as part of a medical student course. I am excited to connect with others about this important work. Below you will find my work plan that I will be implementing over the next few weeks. I am extremely open to suggestions, feedback, and edits! Nice to meet you all!

Work Plan

- Areas of Focus:

---Lead/Intro Section: I would like to expand this section to clarify the definitions of gender identity. Additionally, I would like to emphasize the use of the phrasing: "gender-affirming hormone therapy", as this is the widely accepted terminology used within the LGBTQ+ and medical communities.

---Requirements: In this section, I will be elaborating and updating the current guidelines for initiating gender-affirming hormone therapy. I will largely be using the World Professional Association for Transgender Health (WPATH) guidelines, as these are the most widely accepted and adhered to guidelines in the medical community.

---Laws/Regulations: If time allows, I am considering adding a section discussing the laws and restrictions surrounding gender-affirming hormone therapy. This is an ever-changing topic, especially in today's political climate. However, as users above me have suggested, this is an important topic of interest. This section can perhaps be a sub-heading under the accessibility section. I would love to hear others' opinions on the inclusion of this top on this page.

---Treatment Options: I plan to entirely revamp this section. Although this page is meant to give a general overview of hormone-affirming hormone therapy, I think this section should be expanded to include more information about the actual treatment options. I plan to expand upon each subsection in this section. I will be paying especially close attention to the safety, side effects, and monitoring of hormone therapy. I am also considering making safety, side effects, and monitoring its own heading. What do others think about this proposed change?

---Treatment Eligibility: I will be double-checking and updating this section with the most up-to-date information utilizing the newest guidelines.

---Accessibility: See my plan for "Laws and Regulations" above. I think this is a very important and timely update to this page. Accessibility and health equity should be included in this section as well.

This was just a brief summary of the updates I plan to make to this page. All of these are proposed changes, and I would be happy to discuss any of these with anyone interested in providing their feedback. Many thanks!

--KevP25 (talk) 15:43, 27 October 2021 (UTC)

Hi Kev, excited to work with you. I'm not sure if you intended your list to be ordered, but I highly recommend working on the sections before revamping the lead. See WP:LEADFOLLOWSBODY. Firefangledfeathers (talk) 15:52, 27 October 2021 (UTC)

GAHT (gender-affirming hormone therapy) is the preferred term, but what about GAT?

"Gender affirming treatments"

I've seen this term used before as well, although it is a bit more all-encompassing than simply just the hormones by its nature. SpiralSource (talk) 15:36, 3 December 2021 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 July 2019 and 23 August 2019. Further details are available on the course page. Student editor(s): Jhum4993, Gabidriller, Tnguyen26, Allydiiorio.

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 23 August 2021 and 8 December 2021. Further details are available on the course page. Student editor(s): Ninty900. Peer reviewers: Nelischalich, Yrodriguez7.

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 25 October 2021 and 19 November 2021. Further details are available on the course page. Student editor(s): KevP25. Peer reviewers: Amcclanahan.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 04:23, 18 January 2022 (UTC)

Out of date tag

Article is out of date. Needs a rewrite, not just focusing on WPATH but on other standards of trans care all over the world, and in 2021. Perhaps there could be a section that talked about historical care versus now. Likeanechointheforest (talk) 16:59, 13 May 2021 (UTC)

I believe this is something that would likely warrant its own article at some point. SpiralSource (talk) 15:34, 3 December 2021 (UTC)

@Likeanechointheforest: What newer standards of care are you referring to? Without mentioning something specific, your suggestion isn't likely to result in any changes. Nosferattus (talk) 21:29, 23 April 2022 (UTC)

Hey, yeah thanks @Nosferattus! The current WPATH standard of care is a decades old and in many cases contradicted by newer research, for example regarding the anti-androgen bicalutamide: https://transfemscience.org/articles/bica-adoption/ Likeanechointheforest (talk) 19:55, 25 April 2022 (UTC)

@Likeanechointheforest: This article is meant to be a broad overview of the subject and doesn't discuss specific medications. The article feminizing hormone therapy goes into more detail and does discuss bicalutamide. Are there any other cases where the WPATH standard of care is contradicted by newer research, especially in ways that would affect this article specifically? I'm not trying to shoot down your suggestions, just looking for some specific ways that the article could be improved by newer research. Nosferattus (talk) 20:39, 25 April 2022 (UTC)

I see what you're saying. No, I agree with you! thanks! Likeanechointheforest (talk) 18:58, 26 April 2022 (UTC)

Wiki Education assignment: Gender and Technoculture 320-01

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 August 2023 and 8 December 2023. Further details are available on the course page. Student editor(s): 43corndogs (article contribs). Peer reviewers: Hannahsooter.

— Assignment last updated by ACHorwitz (talk) 16:18, 10 October 2023 (UTC)

The Cass Review in April 2024 has no mention on this page yet

The Review is about pre-adult transgender care, and included a 4 year University-led study of all available scientific research and clinical practise, worldwide. Regards hormone therapies and puberty blockers in particular, it stated that there is a lack of evidence that they are effective, and a lack of evidecne that they do not have harmful side effects. I'll start things off with a mention of it here. Peckedagain (talk) 23:13, 9 May 2024 (UTC)

It is mentioned on the page. I don't think it needed to be added to the opening like that Zenomonoz (talk) 23:58, 9 May 2024 (UTC)

Agreed, it would not be WP:DUE for its prominent addition to the lead as was tried to be added by @Peckedagain at this point.

It is one report, that was specifically created to inform the guidance for one country, the UK and as such it can have a by-sentence mention on here once it is clear if and how the NHS will actually use the data from the report to inform the UKs gender care guidelines, but it by itself isn't a guideline currently in use. At a point where such a new guideline was made by the NHS a small note about how it may be used there could be added, but it probably is WP:TOOSOON for inclusion on this page here right now since the NHS hasn't finished any implementation of new clear guidelines for which the Cass Review may form the basis. This page gives an overview of Transgender hormone therapy at large and using the guidelines that are currently actively used around the world, such as the Dutch protocol, Endocrine Society and WPATH guidelines, which are listed on Transgender hormone therapy#Guidelines as they are actively in use as a guidelines. Raladic (talk) 01:28, 10 May 2024 (UTC)

I think it would be better introduce that elsewhere in the article, but I also think it would be more pointful to be explicit about what evidence is missing. There's plenty of evidence that cross-sex hormones change bodies. The evidence that's missing is that cross-sex hormones are a net benefit to teenagers' overall lives. WhatamIdoing (talk) 16:47, 10 May 2024 (UTC)

Wiki Education assignment: Information Literacy and Scholarly Discourse

This article was the subject of a Wiki Education Foundation-supported course assignment, between 3 June 2024 and 24 July 2024. Further details are available on the course page. Student editor(s): Jaylak33 (article contribs). Peer reviewers: Dayxna7.

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