Overview
Gender dysphoria involves significant distress due to incongruence between a person's experienced gender and sex assigned at birth. It necessitates comprehensive, multidisciplinary care addressing psychological, medical, and surgical aspects. 178Diagnosis
Management
Special Populations
Key Recommendations
References
1 Cihan H, Bischofberger-Baumann B, Bucher J, Caironi V, Claude F, Del Vento F et al.. Endocrine care of transgender and gender-diverse adults: Swiss recommendations. Swiss medical weekly 2026. link 2 Mamoun L, Miao X, Givant M, Tadevosyan E, Morin E, Choi A et al.. Meeting the Demand: A Comparative Analysis of Plastic Surgery and Urology Gender-Affirming Fellowship Programs. Annals of plastic surgery 2026. link 3 Colvin L, Kemp H. More than a decade with 'gender on the agenda': have we made progress?. British journal of anaesthesia 2026. link 4 J Sanchez K, G Healy M, A Rollins D, A Lea J, S Frey-Vogel A. The Impact of Education on the Perioperative Care of Transgender and Gender Nonbinary Patients on Anesthesia Trainees. AANA journal 2026. link 5 Dominoni M, Scatigno AL, Pasquali MF, Bergante C, Gariboldi F, Gardella B. Pelvic floor and sexual dysfunctions after genital gender-affirming surgery: a systematic review and meta-analysis. The journal of sexual medicine 2025. link 6 Housley PP, Saikaly SK, Jain N, Grant-Kels JM. Ethics of reversible dermatologic care in transgender and gender-diverse adolescents under restrictive and ambiguous laws. Clinics in dermatology 2025. link 7 Sobral LNE, Lima JPV, Silva AM, Monteiro LF, Britto DF, Peixoto RAC. Promoting transgender healthcare competency: simulation scenario for medical students. BMC medical education 2025. link 8 Streeter L, Barrera E, Adler M, Redwood E, Boskey ER, Pollock N et al.. Toward the inclusion of transgender and nonbinary residents among obstetrics and gynecology residency programs across the nation: a needs assessment. American journal of obstetrics and gynecology 2025. link 9 Parsons D, Blew K, Adkins D, Johnston KJB, Bradley KE, Wittstein J. Expert Care of Adolescent Transgender and Gender-diverse Athletes. Sports medicine and arthroscopy review 2025. link 10 Esfahani K, Hopf H, Forkin KT. The Creation and Impact of Leadership Development Programs for Women in Medicine with a Focus on Anesthesiology. Anesthesiology clinics 2025. link 11 Krueger ME, Roque RA, Reece-Nguyen TL, MacCormick H. Analysis of Transgender and Gender-Diverse Topics Within Diversity, Equity, and Inclusion Curricular Content in Pediatric Anesthesiology Fellowship Programs in the United States and Canada-A Prospective Survey. Paediatric anaesthesia 2025. link 12 Oulousian E, Graham ME, Chan Y, Lea J, Hu A. Creation and Program Evaluation of a Women in Surgery in ENT (WISE) Group. Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 2025. link 13 Pérez-López EM, Roldán JN, Rojas LMH, Martín CMJ, Pérez MR, Kolly MNM et al.. Evaluation of Potential Adverse Effects of Gender-Affirming Hormonal Therapy; Findings from the Spanish Pharmacovigilance System Database. Journal of clinical pharmacology 2025. link 14 Laspro M, Hoffman A, Chinta S, Abdalla J, Tran D, Oh C et al.. The Effects of Perioperative Gender-affirming Hormone Therapy on Facial Feminization Surgery Adverse Events, Facial Features Addressed, and Esthetic Satisfaction: A Multimodal Analysis. The Journal of craniofacial surgery 2025. link 15 Gómez Hoyos E, Cabrera García P, Gómez Balaguer M. Executive summary: Quality standards of care units for people with sexual and gender diversity. Endocrinologia, diabetes y nutricion 2024. link 16 Wang T. Sex reconfigured: DIY hormone therapy and vernacular endocrinology in transfeminine communities in China. Social science & medicine (1982) 2024. link 17 Higgins FB, Dearborn HL, Smalley JM. Transgender and Gender Diverse Health Care in the US Military: What Dermatologists Need to Know. Cutis 2024. link 18 Kuperman Wilder L, Orsi V, Chebi G, Balague MA, Cabral Campana L. Two years of innovative dermatological care: the first public health consultation service for the transgender and gender diverse community in Argentina. Anais brasileiros de dermatologia 2024. link 19 Wong RK, Harrington J, Stevenson AI. Dermatological care of gender-diverse patients in Australia. The Australasian journal of dermatology 2024. link 20 Castañeda MFO, Cortés HT, Isaac NG, Cárdenas CM. Skin manifestations in adults with gender dysphoria on hormone treatment in the outpatient clinic of Hospital de San José, Bogotá-Colombia. International journal of dermatology 2024. link 21 Seizilles de Mazancourt E, Cotte J, Pinar U, Goujon A, Taha F, Seguier D et al.. Barriers for pregnancy and perceptions of gender discrimination of urologists in training in France: Results of a national survey. The French journal of urology 2024. link 22 Krakowsky Y, Shah G, Nguyen AV, Kavanagh AG, Potter E, Remondini T et al.. Gender-affirming care in urology: emergency care of the gender-affirming surgical patient-what the primary urologist needs to know. BJU international 2024. link 23 Eble DJ, Nguyen AL, Roblee CV, Tople TL, Friedrich JB, Skokan AJ et al.. Conscientious Objection to Gender-Affirming Surgery: A Cross-Sectional Analysis of Plastic Surgery and Urology Residency Programs. Journal of surgical education 2024. link 24 Winkel AF, Katz NT. The Role of Obstetrics and Gynecology in Shaping Gender-diverse Leadership in Medicine. Clinical obstetrics and gynecology 2024. link 25 Kalayjian A, Laszlo K, Fassler M, Schonrock Z, Delarose KE, Ly AM et al.. Patterns of psychotropic medication prescribing and potential drug-hormone interactions among transgender and gender-diverse adults within 2 years of hormone therapy. Journal of the American Pharmacists Association : JAPhA 2024. link 26 Gomez-Lumbreras A, Villa-Zapata L. Exploring Safety in Gender-Affirming Hormonal Treatments: An Observational Study on Adverse Drug Events Using the Food and Drug Administration Adverse Event Reporting System Database. The Annals of pharmacotherapy 2024. link 27 Doan TC, Wood Matabele KL, Nicksic PJ, Gast KM, Poore SO. Database Tracking in Gender-Affirming Surgery: Are Patients Falling Through the Cracks?. WMJ : official publication of the State Medical Society of Wisconsin 2023. link 28 Ciancia S, Iughetti L. How do Italian pediatric endocrinologists approach gender incongruence?. Italian journal of pediatrics 2023. link 29 Cocchetti C, Castellini G, Maggi M, Romani A, Vignozzi L, Greenman Y et al.. Effects of hormonal treatment on dermatological outcome in transgender people: a multicentric prospective study (ENIGI). Journal of endocrinological investigation 2023. link 30 Maffucci F, Clark J, Jun M, Douglass L. A Urologist's Guide to Caring for Transgender and Gender Diverse Patients. The Urologic clinics of North America 2023. link 31 Sineath RC, Hennig F, Dy GW. Management of Urologic Complications After Genital Gender-Affirming Surgery in Transgender and Nonbinary Patients. The Urologic clinics of North America 2023. link 32 Baecher-Lind L, Sutton JM, Bhargava R, Chen KT, Fleming A, Morgan HK et al.. Strategies to Create a More Gender Identity Inclusive Learning Environment in Preclinical and Clinical Medical Education. Academic medicine : journal of the Association of American Medical Colleges 2023. link 33 Eberman LE, Winkelmann ZK, Crossway AK, Lopez RM, Nye EA, Rogers SM et al.. Sports Medicine Physicians Comfort and Competence in Caring for Transgender and Gender Nonconforming Patients and Athletes. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 2023. link 34 Schwarz K, Cielo CA, Spritzer PM, Villas-Boas AP, Costa AB, Fontanari AMV et al.. A speech therapy for transgender women: an updated systematic review and meta-analysis. Systematic reviews 2023. link 35 Leyns C, Daelman J, Adriaansen A, Tomassen P, Morsomme D, T'Sjoen G et al.. Short-Term Acoustic Effects of Speech Therapy in Transgender Women: A Randomized Controlled Trial. American journal of speech-language pathology 2023. link 36 Bunderen CCV, Leentjens J, Middeldorp S. Transgender Medicine and Risk of Venous Thromboembolism. Hamostaseologie 2022. link 37 Beuttler M, MacGregor J. A Genderfluid Approach to Aesthetic Language in Dermatology. Journal of drugs in dermatology : JDD 2022. link 38 Love JS, Zeidan AJ, Khatri UG, Samuels-Kalow ME, Mills AM, Hsu CH. WOMen profEssioNal developmenT oUtcome Metrics in Academic Emergency Medicine: Results from the WOMENTUM Modified Delphi Study. The western journal of emergency medicine 2022. link 39 Lifshitz D, Yaish I, Wagner-Kolasko G, Greenman Y, Sofer Y, Alpern S et al.. Transgender men's preferences when choosing obstetricians and gynecologists. Israel journal of health policy research 2022. link 40 Magrath WJ. The Fall of the Nation's First Gender-Affirming Surgery Clinic. Annals of internal medicine 2022. link 41 Nuyen BA, Thomas JP. Opportunities for Gender-Affirming Surgery Training in Residency and Fellowship. Otolaryngologic clinics of North America 2022. link 42 Mitsopoulou D, Papadopoulos A, Papadopoulou-Skordou E, Papathanasiou AA, Papapetrou C, Vlahos N. Gender dysphoria in the field of obstetrics and gynecology. Med (New York, N.Y.) 2021. link 43 Rosenthal SM. Challenges in the care of transgender and gender-diverse youth: an endocrinologist's view. Nature reviews. Endocrinology 2021. link 44 Hanley K, Wittenberg H, Gurjala D, Safir MH, Chen EH. Caring for Transgender Patients: Complications of Gender-Affirming Genital Surgeries. Annals of emergency medicine 2021. link 45 Swink SM, Castelo-Soccio L. Dermatologic considerations for transgender and gender diverse youth. Pediatric dermatology 2021. link 46 Mishra P, Nath A, Kaushal A, Kain R. Gender reassignment surgery - a narrative overview of anaesthetic considerations and implications. Anaesthesiology intensive therapy 2021. link 47 Lindsay R. Gender-Based Pay Discrimination in Otolaryngology. The Laryngoscope 2021. link 48 Oğuz Ö, Ayran B, Yelken K. Clinical Considerations in Speech and Language Therapy in Turkish Transgender Population. Journal of voice : official journal of the Voice Foundation 2021. link 49 Hughes M, Nikolavsky D, Ginzburg N. Transgender Surgery and Outcomes: Focused for the FPMRS Provider. Female pelvic medicine & reconstructive surgery 2020. link 50 Pilgrim D, Entwistle K. GnRHa ('Puberty Blockers') and Cross Sex Hormones for Children and Adolescents: Informed Consent, Personhood and Freedom of Expression. The New bioethics : a multidisciplinary journal of biotechnology and the body 2020. link 51 Prince JCJ, Safer JD. Endocrine treatment of transgender individuals: current guidelines and strategies. Expert review of endocrinology & metabolism 2020. link 52 Janeway H, Coil CJ. Emergency care for transgender and gender-diverse children and adolescents. Pediatric emergency medicine practice 2020. link 53 Khatri UG, Love J, Zeidan A, Hsu CH, Mills AM. #Shemergency: Use of a Professional Development Group to Promote Female Resident Recruitment and Retention. Academic medicine : journal of the Association of American Medical Colleges 2020. link 54 Lu DW, Lall MD, Mitzman J, Heron S, Pierce A, Hartman ND et al.. #MeToo in EM: A Multicenter Survey of Academic Emergency Medicine Faculty on Their Experiences with Gender Discrimination and Sexual Harassment. The western journal of emergency medicine 2020. link 55 Buhalog B, Peebles JK, Mansh M, Kim EA, Knott PD, Hoffman W et al.. Trainee Exposure and Education for Minimally Invasive Gender-Affirming Procedures. Dermatologic clinics 2020. link 56 MacGregor JL, Chang YC. Minimally Invasive Procedures for Gender Affirmation. Dermatologic clinics 2020. link 57 Mendiola M, Chu J, Haviland MJ, Meservey M, Hacker MR, Gomez-Carrion Y. Barriers to care and reproductive considerations for transmasculine gender affirming surgery. American journal of obstetrics and gynecology 2020. link 58 Shaw MK, Chandratilake M, Ho MJ, Rees CE, Monrouxe LV. Female victims and female perpetrators: medical students' narratives of gender dynamics and professionalism dilemmas. Advances in health sciences education : theory and practice 2020. link 59 Sbragia JD, Vottero B. Experiences of transgender men in seeking gynecological and reproductive health care: a qualitative systematic review. JBI evidence synthesis 2020. link 60 Roque RA. Transgender pediatric surgical patients-Important perioperative considerations. Paediatric anaesthesia 2020. link 61 Lennie Y, Leareng K, Evered L. Perioperative considerations for transgender women undergoing routine surgery: a narrative review. British journal of anaesthesia 2020. link 62 Humble RM, Imborek KL, Nisly N, Greene DN, Krasowski MD. Common Hormone Therapies Used to Care for Transgender Patients Influence Laboratory Results. The journal of applied laboratory medicine 2019. link 63 Moyer DN, Connelly KJ, Holley AL. Using the PHQ-9 and GAD-7 to screen for acute distress in transgender youth: findings from a pediatric endocrinology clinic. Journal of pediatric endocrinology & metabolism : JPEM 2019. link 64 T'Sjoen G, Arcelus J, Gooren L, Klink DT, Tangpricha V. Endocrinology of Transgender Medicine. Endocrine reviews 2019. link 65 Marshall AG, Sista P, Colton KR, Fant A, Kim HS, Lank PM et al.. Women's Night in Emergency Medicine Mentorship Program: A SWOT Analysis. The western journal of emergency medicine 2019. link 66 Hansen M, Schoonover A, Skarica B, Harrod T, Bahr N, Guise JM. Implicit gender bias among US resident physicians. BMC medical education 2019. link 67 Rajanala S, Maymone MB, Vashi NA. Sexual dimorphism and transgender medicine: appealing to a viewer's sense of beauty. Dermatology online journal 2019. link 68 Jarin J. The Ob/Gyn and the transgender patient. Current opinion in obstetrics & gynecology 2019. link 69 Brunskell-Evans H. The Medico-Legal 'Making' of 'The Transgender Child'. Medical law review 2019. link 70 Gray ML, Courey MS. Transgender Voice and Communication. Otolaryngologic clinics of North America 2019. link 71 Ellis SA, Dalke L. Midwifery Care for Transfeminine Individuals. Journal of midwifery & women's health 2019. link 72 Pan S, Honig SC. Gender-Affirming Surgery: Current Concepts. Current urology reports 2018. link 73 Salehi P, Divall SA, Crouch JM, Hopkinson RA, Kroon L, Lawrence J et al.. Review of Current Care Models for Transgender Youth and Application to the Development of a Multidisciplinary Clinic - The Seattle Children's Hospital Experience. Pediatric endocrinology reviews : PER 2018. link 74 Moravek MB. Gender-Affirming Hormone Therapy for Transgender Men. Clinical obstetrics and gynecology 2018. link 75 Randolph JF. Gender-Affirming Hormone Therapy for Transgender Females. Clinical obstetrics and gynecology 2018. link 76 Massenburg BB, Morrison SD, Rashidi V, Miller C, Grant DW, Crowe CS et al.. Educational Exposure to Transgender Patient Care in Otolaryngology Training. The Journal of craniofacial surgery 2018. link 77 Tangpricha V, Hannema SE, Irwig MS, Meyer WJ, Safer JD, Hembree WC. 2017 AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/ENDOCRINE SOCIETY UPDATE ON TRANSGENDER MEDICINE: CASE DISCUSSIONS. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2017. link 78 Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema SE, Meyer WJ, Murad MH et al.. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. The Journal of clinical endocrinology and metabolism 2017. link 79 Conard LE. Supporting and caring for transgender and gender nonconforming youth in the urology practice. Journal of pediatric urology 2017. link 80 Morrison SD, Dy GW, Chong HJ, Holt SK, Vedder NB, Sorensen MD et al.. Transgender-Related Education in Plastic Surgery and Urology Residency Programs. Journal of graduate medical education 2017. link 81 . Committee Opinion No. 685: Care for Transgender Adolescents. Obstetrics and gynecology 2017. link 82 Hermosura Almazan T, Kabigting FD. Dermatologic care of the transgender patient. Dermatology online journal 2016. link 83 Ginsberg BA, Calderon M, Seminara NM, Day D. A potential role for the dermatologist in the physical transformation of transgender people: A survey of attitudes and practices within the transgender community. Journal of the American Academy of Dermatology 2016. link 84 Hancock AB, Stutts HW, Bass A. Perceptions of Gender and Femininity Based on Language: Implications for Transgender Communication Therapy. Language and speech 2015. link 85 Sadjadi S. The endocrinologist's office-puberty suppression: saving children from a natural disaster?. The Journal of medical humanities 2013. link 86 McGregor AJ, Choo E. Gender-specific medicine: yesterday's neglect, tomorrow's opportunities. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2012. link 87 Hancock A, Helenius L. Adolescent male-to-female transgender voice and communication therapy. Journal of communication disorders 2012. link 88 Dacakis G, Oates J, Douglas J. Beyond voice: perceptions of gender in male-to-female transsexuals. Current opinion in otolaryngology & head and neck surgery 2012. link 89 Rupert JL. Genitals to genes: the history and biology of gender verification in the Olympics. Canadian bulletin of medical history = Bulletin canadien d'histoire de la medecine 2011. link 90 Carew L, Dacakis G, Oates J. The effectiveness of oral resonance therapy on the perception of femininity of voice in male-to-female transsexuals. Journal of voice : official journal of the Voice Foundation 2007. link 91 Houk CP, Lee PA. The diagnosis and care of transsexual children and adolescents: a pediatric endocrinologists' perspective. Journal of pediatric endocrinology & metabolism : JPEM 2006. link 92 Kanagalingam J, Georgalas C, Wood GR, Ahluwalia S, Sandhu G, Cheesman AD. Cricothyroid approximation and subluxation in 21 male-to-female transsexuals. The Laryngoscope 2005. link 93 Sweet M. Tough at the top. BMJ (Clinical research ed.) 2004. link 94 Michel A, Mormont C, Legros JJ. A psycho-endocrinological overview of transsexualism. European journal of endocrinology 2001. link 95 Van Borsel J, De Cuypere G, Van den Berghe H. Physical appearance and voice in male-to-female transsexuals. Journal of voice : official journal of the Voice Foundation 2001. link00059-5) 96 Roberts JP, Hutson JM. Reduction of scrotalized skin improves the cosmetic appearance of feminising genitoplasty. Pediatric surgery international 1997. link 97 Simpson JL, Ljungqvist A, de la Chapelle A, Ferguson-Smith MA, Genel M, Carlson AS et al.. Gender verification in competitive sports. Sports medicine (Auckland, N.Z.) 1993. link 98 Walinder J, Thuwe I. A law concerning sex reassignment of transsexuals in Sweden. Archives of sexual behavior 1976. link 99 Hore BD, Nicolle FV, Calnan JS. Male transsexualism in England: sixteen cases with surgical intervention. Archives of sexual behavior 1975. link