Test

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Summarized Treatment Timeline[edit]

Adolescents[edit]

    1. do not suppress hormones prior to puberty [footnote 1]
    2. do not administer a sex hormone regimen before puberty [footnote 1]
    1. wait until tanner stage 2 (first signs of puberty) before suppressing pubertal hormones[footnote 2]
    2. if the patient has mental capacity to consent to reversible treatment, make sure they meet the criteria for GnRH agonist treatment prior to prescription[footnote 3]
    1. Obtain baseline readings according to "Baseline and Follow-up Protocol During Suppression of Puberty"
    2. Proceed with treatment according to "Baseline and Follow-up Protocol During Suppression of Puberty"
    1. wait until patient has mental capacity to consent to irreversible treatment before adminstering a sex hormone regimen (usually age 16)[footnote 4]
    2. exceptions to the age guideline of 16 years old for sex hormone administration may be made in some exceptional cases[footnote 5]
    3. make sure the patient meets the other criteria for sex hormone treatment prior to prescription
    1. Obtain baseline readings according to "Baseline and Follow-up Protocol During Induction of Puberty"
    2. Proceed according to "Protocol Induction of Puberty"
    1. Adjust maintenance dose and watch for negative side effects as described in "Continued Monitoring of Hormone Therapy"
    2. Consider the alternative medications or routes of administration found in "Hormone Regimens in Transgender Persons"

Adults[edit]

If clinic uses SOC model[edit]

NOTE: There is some debate as to the ethicality of the SOC model.[1]

  1. A psychosocial assessment is required by a qualified mental health professional
  2. Make sure the patient meets the "Criteria for Gender-Affirming Hormone Therapy for Adults" or wait until they do.
  3. Upon evaluation the qualified mental health professional provides a referral letter for treatment (unless the assessment is done by the hormone provider).
  4. There are some circumstances where it is acceptable to prescribe hormones to patients who do not fit these criteria, for example:
    • Providing monitored therapy using hormones of known quality as an alternative to illicit or unsupervised hormone use with self medicating patients
    • Patients who have already established themselves in their affirmed gender and who have a history of prior hormone use
  5. Begin providing HRT according do the guidelines found in #Regimens.

If clinic uses ICATH model[2][edit]

  1. The patient makes an appointment with their medical provider to discuss the gender affirming medical care they're plan on obtaining. They let this provider know they intend to use Informed Consent as a means to access your basic right to medical care.
  2. They attend an initial medical appointment with the medical provider you choose. They may bring a pre-prepared letter to introduce their intent to use informed consent to access medical care.
  3. If their provider tells the patient they will not use informed consent and that they need a letter from a therapist, they can produce a letter following this format with a therapist/advocate. The patient can work with a therapist to adapt this letter to best meet their needs.
  4. They meet with their medical provider to get the care they need.
  5. They begin providing HRT according do the guidelines found in #Regimens.


Summarized Treatment Timeline[edit]

Adolescents[edit]

    1. do not suppress hormones prior to puberty [footnote 1]
    2. do not administer a sex hormone regimen before puberty [footnote 1]
    1. wait until tanner stage 2 (first signs of puberty) before suppressing pubertal hormones[footnote 2]
    2. if the patient has mental capacity to consent to reversible treatment, make sure they meet the criteria for GnRH agonist treatment prior to prescription[footnote 3]
    1. Obtain baseline readings according to "Baseline and Follow-up Protocol During Suppression of Puberty"
    2. Proceed with treatment according to "Baseline and Follow-up Protocol During Suppression of Puberty"
    1. wait until patient has mental capacity to consent to irreversible treatment before adminstering a sex hormone regimen (usually age 16)[footnote 4]
    2. exceptions to the age guideline of 16 years old for sex hormone administration may be made in some exceptional cases[footnote 5]
    3. make sure the patient meets the other criteria for sex hormone treatment prior to prescription
    1. Obtain baseline readings according to "Baseline and Follow-up Protocol During Induction of Puberty"
    2. Proceed according to "Protocol Induction of Puberty"
    1. Adjust maintenance dose and watch for negative side effects as described in "Continued Monitoring of Hormone Therapy"
    2. Consider the alternative medications or routes of administration found in "Hormone Regimens in Transgender Persons"

Adults[edit]

If clinic uses SOC model[edit]

NOTE: There is some debate as to the ethicality of the SOC model.[3]

  1. A psychosocial assessment is required by a qualified mental health professional
  2. Make sure the patient meets the "Criteria for Gender-Affirming Hormone Therapy for Adults" or wait until they do.
  3. Upon evaluation the qualified mental health professional provides a referral letter for treatment (unless the assessment is done by the hormone provider).
  4. There are some circumstances where it is acceptable to prescribe hormones to patients who do not fit these criteria, for example:
    • Providing monitored therapy using hormones of known quality as an alternative to illicit or unsupervised hormone use with self medicating patients
    • Patients who have already established themselves in their affirmed gender and who have a history of prior hormone use
  5. Begin providing HRT according do the guidelines found in #Regimens.

If clinic uses ICATH model[4][edit]

  1. The patient makes an appointment with their medical provider to discuss the gender affirming medical care they're plan on obtaining. They let this provider know they intend to use Informed Consent as a means to access your basic right to medical care.
  2. They attend an initial medical appointment with the medical provider you choose. They may bring a pre-prepared letter to introduce their intent to use informed consent to access medical care.
  3. If their provider tells the patient they will not use informed consent and that they need a letter from a therapist, they can produce a letter following this format with a therapist/advocate. The patient can work with a therapist to adapt this letter to best meet their needs.
  4. They meet with their medical provider to get the care they need.
  5. They begin providing HRT according do the guidelines found in #Regimens.


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