Hormone Therapy and Surgery

A good place to start when looking for  more information about gender confirming surgery and other medical interventions is to review the World Professional Association for Transgender Health (WPATH) Standards of Care (SOC), Version VIII. This edition is freely available for viewing online as a PDF. The WPATH SOC guidelines are an important reference for both individuals who desire gender affirming medical care, as well as anyone else interested in the topic or wanting to support trans loved ones.  Many US-based health insurance companies base their coverage of gender affirming medical interventions on the WPATH SOCs, so it can be helpful to be familiar with them. 

Clinical research and social science studies have advanced the understanding of trans  identity, and there have been many positive changes regarding social acceptance and access to treatment.   The intention of the SOC is to recommend standards of diagnosis, care, and treatment to help individuals achieve quality of life and satisfaction  specific to their gender.  The SOC allows for variations in treatment to suit the many varieties and degrees of Gender Dysphoria, which is the current “diagnosis” used in the medical treatment of trans patients.

Recommendations differ for hormone therapy. For top surgery, hormone therapy is not a prerequisite for patients over 18 years old. Some patients will undergo hormone therapy to alter voice, skin, and hair patterns before top surgery, while others opt just for top surgery. While not an explicit criterion, it is recommended that patients interested in breast augmentation access feminizing hormone therapy (minimum 12 months) prior to breast augmentation surgery in order to maximize breast growth to obtain better surgical (aesthetic) results.

It is important to note that because the Gender Confirmation Center uses the informed consent model and is committed to establishing a surgical practice inclusive of non-binary identities and experiences, we do not require that patients undergo hormone replacement therapy (HRT) as a prerequisite to surgery, with the exception of bottom surgery.

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