Serving transgender people: clinical care considerations and service delivery models in transgender health

The Lancet

Volumn 388, Issue 10042, 2016, Pages 401-411

  Wylie, Kevan ^a,b   Knudson, Gail ^c   Khan, Sharful Islam ^d   Bonierbale, Mireille ^f   Watanyusakul, Suporn ^g   Baral, Stefan ^e  

^a UNIVERSITY OF SHEFFIELD   (United Kingdom)

^b Porterbrook Clinic   (United Kingdom)

^c UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^d INTERNATIONAL CENTRE FOR DIARRHOEAL DISEASE RESEARCH   (Bangladesh)

^e JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

^f HÔPITAL DE LA CONCEPTION   (France)

^g Aikchol Hospital   (Thailand)

Author keywords

[No Author keywords available]

Indexed keywords

COST; COUNSELING; DECISION MAKING; GAMETE; GENDER; HAIR REMOVAL; HEALTH; HEALTH CARE; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH PRACTITIONER; HORMONAL THERAPY; HUMAN; MENTAL HEALTH; OCCUPATIONAL THERAPY; OUTCOME ASSESSMENT; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; PSYCHOTHERAPY; REVIEW; SPEECH AND LANGUAGE REHABILITATION; SURGICAL TECHNIQUE; TRANSGENDER; TRANSITIONAL CARE; GENDER IDENTITY; MENTAL HEALTH SERVICE; NONBIOLOGICAL MODEL; ORGANIZATION AND MANAGEMENT; PSYCHOLOGY; STANDARDS; TRANSSEXUALISM;

DELIVERY OF HEALTH CARE; GENDER IDENTITY; HUMANS; MENTAL HEALTH SERVICES; MODELS, ORGANIZATIONAL; QUALITY OF HEALTH CARE; TRANSGENDER PERSONS; TRANSSEXUALISM;

EID: 84982095343     PISSN: 01406736     EISSN: 1474547X     Source Type: Journal    
DOI: 10.1016/S0140-6736(16)00682-6     Document Type: Review

References (106)

1. 1 Coleman, E, Bockting, M, Botzer, P, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgender 13 (2012), 165–232.
2. 2 Connell, RW, Gender, 2002, Polity, UK.
3. 3 Wirth, JH, Bodenhausen, GV, The role of gender in mental-illness stigma: a national experiment. Psychol Sci 20 (2009), 169–173.
4. 4 Khan, SI, Hussain, MI, Parveen, S, et al. Living on the extreme margin: social exclusion of the transgender population (hijra) in Bangladesh. J Health Popul Nutr 27 (2009), 441–451.
5. 5 Hines, S, Transforming gender: transgender practices of identity, intimacy and care, 2007, The Policy Press, University of Bristol, Bristol.
6. 6 Rice, ME, Harris, GT, Is androgen deprivation therapy effective in the treatment of sex offenders?. Psychol Public Policy Law 17 (2011), 315–332.
7. 7 Sam, H, Transgender representations, 2010, Singapore, National University of Singapore.
8. 8 Chokrungvaranont, P, Selvaggi, G, Jindarak, S, et al. The development of sex reassignment surgery in Thailand: a social perspective. Scientific World J, 2014, 2014, 182981.
9. 9 Doussantousse, S, Sakounnavong, B, Patterson, I, An expanding sexual economy along National Route 3 in Luang Namtha Province, Lao PDR. Cult Health Sex 13:suppl 2 (2011), S279–S291.
10. 10 Pew Research Center. The global divide on homosexuality. Greater acceptance in more secular and affluent countries. http://www.pewglobal.org/files/2013/06/Pew-Global-Attitudes-Homosexuality-Report-FINAL-JUNE-4-2013.pdf, 2013 (accessed May 22, 2016).
11. 11 Melayu, B, World Report 2015, 2015, Human Rights Watch, Malaysia.
12. 12 Offord, B, Cantrell, L, Homosexual rights as human rights in Indonesia and Australia. J Homosex 40 (2001), 233–252.
13. 13 Laurent, E, Sexuality and human rights: an Asian perspective. J Homosex 48 (2005), 163–225.
14. 14 Nandi J. Germany got it right by offering a third gender option on birth certificates. Guardian (London), 2013.
15. 15 Karim, M, Hijras now a separate gender. Dhaka Tribune (Dhaka), 2013.
16. 16 Mahapatra, D, Supreme court recognizes transgenders as ‘third gender’. Times of India (New Delhi), 2014.
17. 17 Chin, J, Nepal issues its first third-gender passport to recognize LGBT citizens. Huffington Post Canada, 2015.
18. 18 Vidal-Ortiz, S, Transgender and Transsexual Studies: Sociology's Influence and Future Steps. Soc Compass 2 (2008), 433–450.
19. 19 Guadamuz, TE, Wimonsate, W, Varangrat, A, et al. HIV prevalence, risk behavior, hormone use and surgical history among transgender persons in Thailand. AIDS Behav 15 (2011), 650–658.
20. 20 Winter, S, Doussantousse, S, Transpeople, hormones, and health risks in southeast Asia: a Lao Study. Int J Sex Health 21 (2009), 35–48.
21. 21 Master, V, Santucci, R, An American hijra: a report of a case of genital self-mutilation to become India's “third sex”. Urology, 62, 2003, 1121.
22. 22 Nanda, S, Neither man nor woman, 1990, Wadsmorth Publishing, Belmont.
23. 23 Nanda, S, The hijras of India: cultural and individual dimensions of an institutionalized third gender role. J Homosex 11 (1985), 35–54.
24. 24 Shreshtha, S, Exploring the consequences of castration in thelife of hijra in Bangladesh, 2011, BRAC University, Dhaka.
25. 25 Khan, SI, Hussain, MI, Gourab, G, Parveen, S, Bhuiyan, MI, Sikder, J, Not to stigmatize but to humanize sexual lives of the transgender (hijra) in Bangladesh: condom chat in the AIDS era. J LGBT Health Res 4 (2008), 127–141.
26. 26 Brett, MA, Roberts, LF, Johnson, TW, Wassersug, RJ, Eunuchs in contemporary society: expectations, consequences, and adjustments to castration (part II). J Sex Med 4 (2007), 946–955.
27. 27 Masumori, N, Status of sex reassignment surgery for gender identity disorder in Japan. Int J Urol 19 (2012), 402–414.
28. 28 Wassersug, RJ, Johnson, TW, Modern-day eunuchs: motivations for and consequences of contemporary castration. Perspect Biol Med 50 (2007), 544–556.
29. 29 Monro, S, Transmuting gender binaries: the theoretical challenge. Sociol Res Online, 12, 2007, 10.5153/sro.1514.
30. 30 Reisner, SL, Bradford, J, Hopwood, R, et al. Comprehensive transgender healthcare: the gender affirming clinical and public health model of fenway health. J Urban Health 92 (2015), 584–592.
31. 31 Hembree, WC, Cohen-Kettenis, P, Delemarre-van de Waal, HA, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 94 (2009), 3132–3154.
32. 32 Wylie, KR, Fung, R Jr, Boshierd, C, Rotchell, M, Recommendations of endocrine treatment for patients with gender dysphoria. Sex Relatsh Ther 24 (2009), 175–187.
33. 33 Gooren, LJ, Clinical practice. Care of transsexual persons. N Engl J Med 364 (2011), 1251–1257.
34. 34 Safer, J, Weinland, J, Hormone therapy in transgender adults is safe with provider supervision: a review of hormone therapy sequelae for transgender individuals. J Clin Transl Endocrinol 2 (2015), 55–60.
35. 35 Asscheman, H, Giltay, EJ, Megens, JA, de Ronde1, W, van Trotsenburg, MA, Gooren, LG, A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. Eur J Endocrinol 164 (2011), 635–642.
36. 36 Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf (accessed May 23, 2016).
37. 37 Byne, W, Bradley, SJ, Coleman, E, et al. Treatment of gender identity disorder. Am J Psychiatry 169 (2012), 875–876.
38. 38 Dhejne, C, Lichtenstein, P, Boman, M, Johansson, AL, Långström, N, Landén, M, Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PLoS One, 6, 2011, e16885.
39. 39 Wallien, MSC, Cohen-Kettenis, PT, Psychosexual outcome of gender-dysphoric children. J Am Acad Child Adolesc Psychiatry 47 (2008), 1413–1423.
40. 40 Drummond, KD, Bradley, SJ, Peterson-Badali, M, Zucker, KJ, A follow-up study of girls with gender identity disorder. Dev Psychol 44 (2008), 34–45.
41. 41 Steensma, TD, McGuire, JK, Kreukels, BP, Beekman, AJ, Cohen-Kettenis, PT, Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study. J Am Acad Child Adolesc Psychiatry 52 (2013), 582–590.
42. 42 de Vries, ALC, McGuire, JK, Steensma, TD, Wagenaar, EC, Doreleijers, TA, Cohen-Kettenis, PT, Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics 134 (2014), 696–704.
43. 43 de Vries, ALC, Steensma, TD, Doreleijers, TA, Cohen-Kettenis, PT, Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med 8 (2011), 2276–2283.
44. 44 Cohen-Kettenis, PT, Delemarre-van de Waal, HA, Gooren, LJG, The treatment of adolescent transsexuals: changing insights. J Sex Med 5 (2008), 1892–1897.
45. 45 de Vries, AL, Doreleijers, TA, Cohen-Kettenis, PT, Disorders of sex development and gender identity outcome in adolescence and adulthood: understanding gender identity development and its clinical implications. Pediatr Endocrinol Rev 4 (2007), 343–351.
46. 46 Dahl, M, Feldman, JL, Goldberg, J, Jaberi, A, Vancouver Coastal Health. Endocrine therapy for transgender adults in British Columbia: suggested guidelines, 2015, Vancouver Coastal Health, Vancouver.
47. 47 Hembree, WC, Cohen-Kettenis, P, Delemarre-van de Waal, HA, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metabol 94 (2009), 3132–3154.
48. 48 Wylie, K, Barrett, J, Besser, M, et al. Good practice guidelines for the assessment and treatment of adults with gender dysphoria. Sex Relatsh Ther 29 (2014), 154–214.
49. 49 Bockting, WO, Psychotherapy and the real-life experience: from gender dichotomy to gender diversity. Sexologies 17 (2008), 211–224.
50. 50 Hedjazi, A, Zarenezhad, M, Hoseinzadeh, A, Hassanzadeh, R, Hosseini, SM, Socio-demographic characteristics of transsexuals referred to the forensic medicine center in southwest of Iran. N Am J Med Sci 5 (2013), 224–227.
51. 51 à Campo, J, Nijman, H, Merckelbach, H, Evers, C, Psychiatric comorbidity of gender identity disorders: a survey among Dutch psychiatrists. Am J Psychiatry 160 (2003), 1332–1336.
52. 52 Gorin-Lazard, A, Bonierbale, M, Magaud-Vouland, N, Michel, A, Gender identity disorder: what is the role of the psychiatrist?. Sexologies 17 (2008), 225–237.
53. 53 Pfaffin, F, Junge, A, Sex reassignment 30 years of international follow-up studies after SRS: a comprehensive review, 1998, Dusseldorf, Germany Symposium Publishing.
54. 54 Lawrence, AA, Factors associated with satisfaction or regret following male-to-female sex reassignment surgery. Arch Sex Behav 32 (2003), 299–315.
55. 55 De Cuypere, G, Elauta, E, Heylens, G, et al. Long-term follow-up: psychosocial outcome of Belgian transsexuals after sex reassignment surgery. Sexologies 15 (2006), 126–133.
56. 56 Bonierbale, M, Magaud-Vouland, N, Retrospective analysis of 128 cases of gender dysphoria. Sexologies 15 (2005), 39–49.
57. 57 Smith, YLS, Van Goozen, SH, Kuiper, AJ, Cohen-Kettenis, PT, Sex reassignment: outcomes and predictors of treatment for adolescent and adult transsexuals. Psychol Med 35 (2005), 89–99.
58. 58 Johansson, A, Sundbom, E, Höjerback, T, Bodlund, O, A five-year follow-up study of Swedish adults with gender identity disorder. Arch Sex Behav 39 (2010), 1429–1437.
59. 59 Gorin-Lazard, A, Baumstarck, K, Boyer, L, et al. Is hormonal therapy associated with better quality of life in transsexuals? A cross-sectional study. J Sex Med 9 (2012), 531–541.
60. 60 Gómez-Gil, E, Zubiaurre-Elorza, L, Esteva, I, et al. Hormone-treated transsexuals report less social distress, anxiety and depression. Psychoneuroendocrinology 37 (2012), 662–670.
61. 61 Bodlund, O, Kullgren, G, Transsexualism—general outcome and prognostic factors: a five-year follow-up study of nineteen transsexuals in the process of changing sex. Arch Sex Behav 25 (1996), 303–316.
62. 62 Michel, A, Ansseau, M, Legros, JJ, Pitchot, W, Mormont, C, The transsexual: what about the future?. Eur Psychiatry 17 (2002), 353–362.
63. 63 Lundström, B, Pauly, I, Wålinder, J, Outcome of sex reassignment surgery. Acta Psychiatr Scand 70 (1984), 289–294.
64. 64 Pfafflin, F, Regrets after sex reassignment surgery. J Psychol Hum Sex 5 (1993), 69–85.
65. 65 McCauley, E, Ehrhardt, AA, Follow-up of females with gender identity disorders. J Nerv Ment Dis 172 (1984), 353–358.
66. 66 Lindemalm, G, Körlin, D, Uddenberg, N, Long-term follow-up of “sex change” in 13 male-to-female transsexuals. Arch Sex Behav 15 (1986), 187–210.
67. 67 Blanchard, R, Steiner, BW, Clemmensen, LH, Dickey, R, Prediction of regrets in postoperative transsexuals. Can J Psychiatry 34 (1989), 43–45.
68. 68 Landén, M, Wålinder, J, Hambert, G, Lundström, B, Factors predictive of regret in sex reassignment. Acta Psychiatr Scand 97 (1998), 284–289.
69. 69 Kuiper, AJ, Cohen-Kettenis, PT, Gender role reversal among postoperative transsexuals. Int J Transgenderism, 2, 1998, 3.
70. 70 Pauly, IB, Outcome of sex reassignment surgery for transsexuals. Aust N Z J Psychiatry 15 (1981), 45–51.
71. 71 Dhejne, C, Van Vlerken, R, Heylens, G, Arcelus, J, Mental health and gender dysphoria: a review of the literature. Int Rev Psychiatr 28 (2016), 44–57.
72. 72 Gorin-Lazard, A, Baumstarck, K, Boyer, L, et al. Hormonal therapy is associated with better self-esteem, mood, and quality of life in transsexuals. J Nerv Ment Dis 201 (2013), 996–1000.
73. 73 Hakeem, A, Psychotherapy for gender identity disorders. Adv Psychiatr Treat 18 (2012), 17–24.
74. 74 Thornton, J, Working with the transgender voice: the role of the speech and language therapist. Sexologies 17 (2008), 271–276.
75. 75 Johnson, A, The development of standards of care for individuals with a male-to-eunich gender identity disorder. Int J Transgend 12 (2010), 40–51.
76. 76 Parker, AJ, Aspects of transgender laryngeal surgery. Sexologies 17 (2008), 277–282.
77. 77 van de Ven, BFML, Facial feminisation, why and how?. Sexologies 17 (2008), 291–298.
78. 78 Monstrey, SJ, Ceulemans, P, Hoebeke, P, Sex reassignment surgery in the female-to-male transsexual. Semin Plast Surg 25 (2011), 229–244.
79. 79 Gilbert, DA, Horton, CE, Terzis, JK, Devine, CJ Jr, Winslow, BH, Devine, PC, New concepts in phallic reconstruction. Ann Plast Surg 18 (1987), 128–136.
80. 80 Hage, JJ, Bouman, FG, de Graaf, FH, Bloem, JJ, Construction of the neophallus in female-to-male transsexuals: the Amsterdam experience. J Urol 149 (1993), 1463–1468.
81. 81 Worathamrong S. Staged approach for female to male reassignment surgery: the way we do to reduce the complications and increase rate of success. 9th International Congress of Oriental Society of Aesthetic Plastic Surgery; Bangkok; 2004.
82. 82 Sengezer, M, Oztürk, S, Deveci, M, Odabaşi, Z, Long-term follow-up of total penile reconstruction with sensate osteocutaneous free fibula flap in 18 biological male patients. Plast Reconstr Surg 114 (2004), 439–450.
83. 83 Perovic, SV, Djordjevic, ML, Metoidioplasty: a variant of phalloplasty in female transsexuals. BJU Int 92 (2003), 981–985.
84. 84 Ousterhout, DK, Feminization of the forehead: contour changing to improve female aesthetics. Plast Reconstr Surg 79 (1987), 701–713.
85. 85 Hage, JJ, Becking, AG, de Graaf, FH, Tuinzing, DB, Gender-confirming facial surgery: considerations on the masculinity and femininity of faces. Plast Reconstr Surg 99 (1997), 1799–1807.
86. 86 Fang, R-H, Chen, C-F, Ma, S, A new method for clitoroplasty in male-to-female sex reassignment surgery. Plast Reconstr Surg 89 (1992), 679–682.
87. 87 Watanyusakul, S, A new method for sensated clitoris and labia minora reconstruction in male-to-female sex-reassignment surgery. Thai J Surgery, 23, 2002, 104.
88. 88 Karim, RB, Hage, JJ, Mulder, JW, Neovaginoplasty in male transsexuals: review of surgical techniques and recommendations regarding eligibility. Ann Plast Surg 37 (1996), 669–675.
89. 89 Reed, HM, Aesthetic and functional male to female genital and perineal surgery: feminizing vaginoplasty. Semin Plast Surg 25 (2011), 163–174.
90. 90 Watanyusakul, S, The effectiveness of full-thickness scrotal and groin skin graft vaginoplasty in MTF sex reassignment surgery. 9th International Congress of Oriental Society of Aesthetic Plastic Surgery; Bangkok. http://www.supornclinic.com/restricted/SRS/SRSPapers.aspx, 2004 (accessed May 23, 2016).
91. 91 Gillott, S, Wylie, K, The clinical value and cost effectiveness of using psychometric-rating scales in the assessment of patients with gender dysphoria. Sexologies 17 (2008), 238–244.
92. 92 Rossi Neto, R, Hintz, F, Krege, S, Rubben, H, Vom Dorp, F, Gender reassignment surgery—a 13 year review of surgical outcomes. Int Braz J Urol 38 (2012), 97–107.
93. 93 Weyers, S, Elaut, E, De Sutter, P, et al. Long-term assessment of the physical, mental, and sexual health among transsexual women. J Sex Med 6 (2009), 752–760.
94. 94 Wierckx, K, Van Caenegem, E, Elaut, E, et al. Quality of life and sexual health after sex reassignment surgery in transsexual men. J Sex Med 8 (2011), 3379–3388.
95. 95 Dowshen, N, Nguyen, GT, Gilbert, K, Feiler, A, Margo, KL, Improving transgender health education for future doctors. Am J Public Health 104 (2014), e5–e6.
96. 96 Safer, JD, Pearce, EN, A simple curriculum content change increased medical student comfort with transgender medicine. Endocr Pract 19 (2013), 633–637.
97. 97 Moll, J, Krieger, P, Moreno-Walton, L, et al. The prevalence of lesbian, gay, bisexual, and transgender health education and training in emergency medicine residency programs: what do we know?. Acad Emerg Med 21 (2014), 608–611.
98. 98 Klotzbaugh, R, Spencer, G, Magnet nurse administrator attitudes and opportunities: toward improving lesbian, gay, bisexual, or transgender-specific healthcare. J Nurs Adm 44 (2014), 481–486.
99. 99 Hardacker, CT, Rubinstein, B, Hotton, A, Houlberg, M, Adding silver to the rainbow: the development of the nurses' health education about LGBT elders (HEALE) cultural competency curriculum. J Nurs Manag 22 (2014), 257–266.
100. 100 McCann, E, Sharek, D, Higgins, A, Sheerin, F, Glacken, M, Lesbian, gay, bisexual and transgender older people in Ireland: mental health issues. Aging Ment Health 17 (2013), 358–365.
101. 101 Bauer, GR, Hammond, R, Travers, R, Kaay, M, Hohenadel, KM, Boyce, M, “I don't think this is theoretical; this is our lives”: how erasure impacts health care for transgender people. J Assoc Nurses AIDS Care 20 (2009), 348–361.
102. 102 Esteva de Antonio, I, Gómez-Gil, E, GIDSEEN Group. Coordination of healthcare for transsexual persons: a multidisciplinary approach. Curr Opin Endocrinol Diabetes Obes 20 (2013), 585–591.
103. 103 Thornhill, L, Klein, P, Creating environments of care with transgender communities. J Assoc Nurses AIDS Care 21 (2010), 230–239.
104. 104 Rager Zuzelo, P, Improving nursing care for lesbian, bisexual, and transgender women. J Obstet Gynecol Neonatal Nurs 43 (2014), 520–530.
105. 105 Association of American Medical Colleges. Implementing curricular and institutional climate changes to improve health care for individuals who are LGBT, gender nonconforming, or born with DSD. AAMC, 2014.
106. 106 Health Policy Project Asia Pacific Transgender Network, United Nations Development Programme. Blueprint for the provision of comprehensive care for trans people and trans communities in Asia and the Pacific, 2015, Washington, DC, UNDP.