| A transsexual is a person who sex-related structures of the brain that define gender identity are exactly opposite the physical sex organs of the body. Many transgender men and women seek hormone therapy as part of the transition process. Medical therapy in transsexualhormonal replacement therapy after 16 years. Suppression of pubertal hormones must be start when girls and boys first exhibit physical changes of puberty (confirmed by pubertal levels of estradiol and testosterone, respectively), but no earlier than Tanner stages 2–3. Pubertal
development of the desired, opposite sex be initiated at the age of 16 year, using a gradually increasing dose schedule of cross-sex steroids. Exogenous testosterone is used in transgender men to induce virilization and suppress feminizing characteristics. In transgender women, xogenous estrogen is used to help feminize patients, and antiandrogens are used as adjuncts to help suppress masculinizing features. Guidelines exist to help providers choose appropriate candidates for hormone therapy, and act as a framework for choosing treatment regimens and
managing surveillance in these patients. Cross-sex hormone therapy has been shown to have positive physical and psychological effects on the transitioning individual and is considered a mainstay treatment for many patients. Genital sex reassignment surgery is recommended only after completion of at least 1 year of consistent and compliant hormone treatment. Transsexual individuals should be monitored by an endocrinologist after surgery. Those who undergo gonadectomy will require hormone replacement therapy or surveillance or both to prevent adverse effects of chronic hormone deficiency. |