Gender-affirming care involves hormone therapy that helps to align an individual's physical characteristics with their gender identity. However, to ensure the safety and effectiveness of these treatments, certain medical considerations must be taken into account. Factors such as age, medical history, and pre-existing health conditions can impact the eligibility of individuals for certain medications commonly used in gender-affirming care.

It is important to understand these medical reasons for ineligibility in order to provide personalized and comprehensive care that meets the unique needs of each individual seeking gender-affirming treatment. 

People who do not have the capacity to consent cannot proceed

In gender-affirming care, ensuring informed consent is fundamental to respecting individuals' autonomy, rights, and dignity.

However, individuals who cannot consent may face barriers to fully understanding the implications, risks, and benefits of hormone therapy. This can stem from various factors, including cognitive limitations, communication barriers, or compromised mental health. Without the ability to comprehend the potential consequences or provide meaningful consent, proceeding with hormone therapy can pose ethical dilemmas and risks to the individual's wellbeing.

Please follow the links for further reading:

Informed Consent in Gender-Affirming Healthcare: Balancing Risks and Benefits

Informed Consent to Medical Treatment – Legal criteria under common jurisdictions

People who have Liver Disease cannot have Cyproterone 

Liver disease encompasses a broad spectrum of conditions, ranging from mild abnormalities in liver enzyme levels to severe cirrhosis or liver failure. In the context of Cyproterone usage, the liver plays a crucial role in metabolizing the medication and clearing it from the body. However, in individuals with liver disease, impaired liver function can affect the body's ability to process and eliminate Cyproterone effectively.

Cyproterone has been associated with hepatotoxicity, meaning it can potentially damage liver cells and worsen existing liver conditions. As a result, individuals with liver disease, or abnormal liver function tests, are advised against using Cyproterone as part of their gender-affirming care. Administrating Cyproterone to such individuals could exacerbate liver damage, leading to adverse health outcomes and complications.

Alternative medications, such as spironolactone or GnRH agonists, are considered to be safer alternatives in individuals with liver disease.

Cyproterone and Liver Disease: Understanding the Potential Risks

Monitoring Liver Enzymes in those Wishing to Take Cyproterone as their Antiandrogen

People who have had breast cancer cannot have Estrogen

Individuals who have previously had breast cancer should not use estrogen as part of gender-affirming care due to the potential risks associated with hormone-sensitive cancers. Estrogen therapy, a key component of feminizing hormone therapy, can stimulate the growth and proliferation of hormone-sensitive breast cancer cells, which can increase the risk of cancer recurrence or progression. Therefore, individuals with a history of breast cancer are advised against estrogen therapy to prioritize their long-term health and reduce the likelihood of cancer recurrence.

You might also be interested in the following knowledge:

Gender Affirming Hormone Treatment and the Risk of Cancer: A Literature Review

Navigating Gender-Affirming Care During Cancer Treatment

People who are on treatment for Blood Pressure or who have Heart Disease / Kidney Disease / Addison's Disease cannot have Spironolactone

For individuals undergoing treatment for blood pressure or those with heart disease, kidney disease, or Addison's disease, the use of Spironolactone in gender affirming care is not recommended due to potential adverse effects and interactions with these medical conditions. It also has diuretic properties that can affect blood pressure regulation and electrolyte balance. In individuals with pre-existing cardiovascular conditions such as heart disease or hypertension, Spironolactone may exacerbate these conditions, leading to complications such as fluid retention or electrolyte imbalances. Similarly, in individuals with kidney disease or Addison's disease, impaired renal function or adrenal insufficiency can affect the body's ability to metabolize and excrete Spironolactone, increasing the risk of adverse effects. Therefore, alternative anti-androgen medications or hormone regimens may be considered for individuals with these medical conditions to ensure the safety and efficacy of gender affirming care while minimizing potential risks to cardiovascular and renal health.

For further reading, please access the following links:

Adrenal Disorders and Spironolactone

Spironolactone in Conjunction with Blood Pressure, Heart, and Kidney Medications

People who are Pregnant / Breast Feeding cannot have Testosterone

Individuals who are pregnant or breastfeeding are advised against testosterone therapy as part of gender affirming care due to potential risks to both the individual and the developing fetus or breastfeeding infant. Testosterone, a key component of masculinizing hormone therapy, can cross the placental barrier during pregnancy or transfer to the infant through breast milk during lactation. Exposure to testosterone during pregnancy may lead to virilization of female fetuses, resulting in potential masculinization of external genitalia or other developmental abnormalities. Similarly, testosterone exposure through breastfeeding may pose risks to the infant's health and development. Therefore, individuals who are pregnant or breastfeeding must stop testosterone therapy until after pregnancy and breastfeeding are completed.

For more information, please follow this link:

Testosterone, Conception and Pregnancy

People who have Prostate cancer cannot have Testosterone

Individuals with prostate cancer are typically advised against testosterone therapy as part of gender affirming care due to potential risks associated with hormone-sensitive tumors. Testosterone, a primary component of masculinizing hormone therapy, can stimulate the growth and proliferation of prostate cancer cells, potentially accelerating tumor growth or increasing the risk of cancer recurrence. Therefore, testosterone therapy is contraindicated in individuals with a history of prostate cancer or those currently undergoing treatment for the disease.

Gender Affirming Hormone Treatment and the Risk of Cancer: A Literature Review

People who have soya allergy cannot have Progesterone Capsules

Individuals who have a soya allergy should refrain from using Progesterone Capsules as part of their gender-affirming care treatment. Progesterone capsules are frequently included in hormone therapy and may contain soy-derived ingredients that can trigger allergic reactions in people with soy allergies. Allergic reactions to soy can range from mild symptoms, such as itching or hives, to more severe responses, such as difficulty breathing or anaphylaxis. Thus, individuals aware of their soy allergies should not use Progesterone Capsules to prevent adverse reactions and ensure their safety throughout hormone therapy.

People who have nut allergy cannot be prescribed Sustanon

Individuals with a nut allergy should not be prescribed Sustanon as part of gender affirming care due to the potential risk of allergic reactions. Sustanon, a commonly used testosterone formulation, may contain ingredients or excipients derived from nuts or nut oils. For individuals with nut allergies, exposure to even trace amounts of nuts can trigger allergic responses ranging from mild symptoms such as itching or hives to severe reactions such as anaphylaxis.

For further reading about this topic, please follow this link:

Allergic Reactions to Medications Cautions, Actions, and Symptoms