Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern India
Context: Awareness of gender dysphoria (GD) and its treatment is increasing. There is paucity of scientific data from India regarding the therapeutic options being used for alleviating GD, which includes psychotherapy, hormone, and surgical treatments. Aim: To study the therapeutic options including...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=3;spage=308;epage=311;aulast=Majumder |
| _version_ | 1818409500037611520 |
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| author | Anirban Majumder Debmalya Sanyal |
| author_facet | Anirban Majumder Debmalya Sanyal |
| author_sort | Anirban Majumder |
| collection | DOAJ |
| description | Context: Awareness of gender dysphoria (GD) and its treatment is increasing. There is paucity of scientific data from India regarding the therapeutic options being used for alleviating GD, which includes psychotherapy, hormone, and surgical treatments. Aim: To study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD. Settings and Design: This is a retrospective study of treatment preferences and outcome in 18 female-to-male (FTM) transgender subjects who presented to the endocrine clinic. Results: The mean follow-up was 1.6 years and only one subject was lost to follow-up after a single visit. All subjects desiring treatment had regular counseling and medical monitoring. All FTM subjects were cross-dressing. Seventeen (94.4%) FTM subjects were receiving cross-sex hormone therapy, in the form of testosterone only (61.1%) or gonadotropin-releasing hormone (GnRH) agonist in combination with testosterone (11.1%) or medroxyprogesterone acetate (MPA) depot in combination with testosterone (22.2%). FTM subjects preferred testosterone or testosterone plus MPA; very few could afford GnRH therapy. Testosterone esters injection was preferred by most (72.2%) subjects as it was most affordable while 22.2% chose 3 monthly injections of testosterone undecanoate for convenience and better symptomatic improvement, but it was more expensive. None preferred testosterone gels because of cost and availability concerns. About 33.3% of our subjects underwent mastectomy, 38.9% had hysterectomy with bilateral salpingo-oophorectomy, and only one subject underwent phalloplasty. About 16.7% of FTM subjects presented with prior mastectomy depicting a high prevalence of unsupervised or poorly supervised surgeries not following protocol wise approach. Conclusion: Notwithstanding of advances in Standards of Care in the Western world, there is lack of awareness and acceptance in the FTM subjects, about proper and timely protocol-wise management options leading to suboptimal physical, social, and sexual results. |
| first_indexed | 2024-12-14T10:00:36Z |
| format | Article |
| id | doaj.art-bc4189e034db406ea6d42f286e105f1a |
| institution | Directory Open Access Journal |
| issn | 2230-8210 2230-9500 |
| language | English |
| last_indexed | 2024-12-14T10:00:36Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-bc4189e034db406ea6d42f286e105f1a2022-12-21T23:07:17ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002016-01-0120330831110.4103/2230-8210.179988Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern IndiaAnirban MajumderDebmalya SanyalContext: Awareness of gender dysphoria (GD) and its treatment is increasing. There is paucity of scientific data from India regarding the therapeutic options being used for alleviating GD, which includes psychotherapy, hormone, and surgical treatments. Aim: To study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD. Settings and Design: This is a retrospective study of treatment preferences and outcome in 18 female-to-male (FTM) transgender subjects who presented to the endocrine clinic. Results: The mean follow-up was 1.6 years and only one subject was lost to follow-up after a single visit. All subjects desiring treatment had regular counseling and medical monitoring. All FTM subjects were cross-dressing. Seventeen (94.4%) FTM subjects were receiving cross-sex hormone therapy, in the form of testosterone only (61.1%) or gonadotropin-releasing hormone (GnRH) agonist in combination with testosterone (11.1%) or medroxyprogesterone acetate (MPA) depot in combination with testosterone (22.2%). FTM subjects preferred testosterone or testosterone plus MPA; very few could afford GnRH therapy. Testosterone esters injection was preferred by most (72.2%) subjects as it was most affordable while 22.2% chose 3 monthly injections of testosterone undecanoate for convenience and better symptomatic improvement, but it was more expensive. None preferred testosterone gels because of cost and availability concerns. About 33.3% of our subjects underwent mastectomy, 38.9% had hysterectomy with bilateral salpingo-oophorectomy, and only one subject underwent phalloplasty. About 16.7% of FTM subjects presented with prior mastectomy depicting a high prevalence of unsupervised or poorly supervised surgeries not following protocol wise approach. Conclusion: Notwithstanding of advances in Standards of Care in the Western world, there is lack of awareness and acceptance in the FTM subjects, about proper and timely protocol-wise management options leading to suboptimal physical, social, and sexual results.http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=3;spage=308;epage=311;aulast=MajumderFemale-to-male transsexualsgender identity disorderhormone and surgical treatmentsIndiapsychotherapy |
| spellingShingle | Anirban Majumder Debmalya Sanyal Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern India Indian Journal of Endocrinology and Metabolism Female-to-male transsexuals gender identity disorder hormone and surgical treatments India psychotherapy |
| title | Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern India |
| title_full | Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern India |
| title_fullStr | Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern India |
| title_full_unstemmed | Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern India |
| title_short | Outcome and preferences in female-to-male subjects with gender dysphoria: Experience from Eastern India |
| title_sort | outcome and preferences in female to male subjects with gender dysphoria experience from eastern india |
| topic | Female-to-male transsexuals gender identity disorder hormone and surgical treatments India psychotherapy |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=3;spage=308;epage=311;aulast=Majumder |
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