Medication step increments for feminising and masculinising hormone treatments are an essential aspect of gender-affirming care. These increments involve the careful titration of hormone medications over time to achieve desired physical changes while minimising potential risks.

For feminising hormone treatment, individuals typically start with a low dose of estrogen and antiandrogens. Gradually, the doses are adjusted based on monitoring of blood hormone levels and the development of secondary sexual characteristics, such as breast development and body fat redistribution.

In contrast, masculinising hormone treatment begins with testosterone therapy, with dosage adjustments based on similar monitoring criteria.

These stepwise increments are essential to provide the right balance of hormones for each individual, ensuring that the effects align with their gender identity and health goals, all while minimising potential side effects and risks. Close collaboration with healthcare providers and regular check-ups are integral to safe and effective hormone therapy.

Monitoring Guidance

• When Prescribing Spironolactone as a Puberty Blocker: It is advisable to monitor the person’s testosterone and potassium levels every 3 months to ensure the medication’s efficacy and safety.
• For People on Spironolactone as an Antiandrogen: Regular testing of testosterone and potassium levels is recommended every 3 months until stability is achieved. Once stable, annual monitoring should suffice.
• In Cases of Cyproterone Acetate as an Antiandrogen: Monitor the person’s testosterone and potassium levels quarterly until they stabilise. Following stabilisation, yearly assessments are appropriate.
• While Administering Testosterone for Masculinisation: Individuals should have their haematocrit and testosterone levels checked every 3 months. After achieving stable testosterone levels, it is prudent to switch to yearly testing.
• For People on Estradiol for Feminisation: Estradiol levels should be monitored quarterly until stability is achieved. Thereafter, annual testing is recommended.

These testing schedules are critical in managing the individual’s transition effectively. Regular monitoring assists in dosage adjustments and early identification of any health concerns, ensuring a safe and successful treatment course.

The GenderGP Commitment

When prescribing protocols for adjusting the dosage of gender-affirming medication, it’s essential to consider a multi-faceted approach. This involves regularly monitoring the individual’s blood tests to ensure that hormone levels are within the desired range, which is crucial for both effectiveness and safety. Additionally, the progress of the individual’s transition should be closely observed, as physical and psychological changes can inform dosage adjustments.

Member preferences and experiences play a significant role in this process. Open and ongoing communication between the healthcare provider and the individual is vital to understand their comfort levels, goals, and any side effects they may be experiencing. This dialogue helps to tailor the treatment plan to the individual’s specific needs and aspirations.

The healthcare provider should also be well-versed in the latest clinical guidelines and research pertaining to gender-affirming care. This knowledge, combined with the individualised considerations of blood test results, transition progress, and member preferences, forms the foundation of a responsive and responsible approach to adjusting dosages of gender-affirming medication.