Protocols for the Initiation of Hormone Therapy for Trans and Gender Diverse Patients

PROTOCOLS FOR THE INITIATION OF HORMONE THERAPY FOR TRANS AND GENDER DIVERSE PATIENTS JUNE 2017 V1.04

These guidelines are designed to reduce barriers and improve health outcomes for trans and gender diverse (TGD) people accessing hormone replacement therapy (HRT).

Under an ‘Informed Consent’ model of care General Practitioners would perform the initial assessment, play a key role in mental health and risk assessments for TGD clients, and organise referral for secondary consultation where required. It would be envisaged that the General Practitioner would remain the primary treating physician for the majority of clients.

These protocols have been developed to reduce unnecessary barriers in accessing HRT. There can be long waiting times at the public Gender Clinics and significant costs involved through the private system. People living in rural and remote areas are often unable to access appropriate health services.

Implementing an ‘Informed Consent’ model of care would reduce waiting times at public mental health services. It would improve access to initiation of HRT for TGD people, particularly those living in rural and remote areas. It may reduce the use of self medicating (buying hormones on line) with the associated medical risks.

We encourage all clients to link in with mental health support throughout transition primarily for dealing with the stress of transition and the potential pressure placed on relationships. A mental health assessment with a Psychiatrist or Psychologist prior to commencing HRT is recommended, but would not be a requirement for clients without significant mental health issues impacting their ability to provide informed consent and a well established desire for medical transition.

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