Sharon
10-19-2006, 11:45 AM
From an e-mail I received a few days ago -- I thought it might be of interest to some of you:
Standards of Care help transgendered
By Angie Fenton
afenton@courier- journal.com
The Courier-Journal
Most reputable therapists and medical doctors who work with
transgender individuals follow the Harry Benjamin Standards of Care,
developed by the late physician, who was one of the first to work
with transgender people.
The goal of the standards is to provide "lasting personal comfort
with the gendered self in order to maximize overall psychological
well-being and self-fulfillment. "
Not all transgender individuals seek professional help. But for
those who do, a timeline might look something like this:
The Standards of Care process
• Personal recognition by an individual that he or she is "living a
lie," as many transgender people describe the experience of feeling
that the gender they were assigned at birth is incorrect.
• A mental health professional diagnoses an individual as suffering
from a genetic identity disorder as laid out in "The Diagnostic and
Statistical Manual of Mental Disorders," published by the American
Psychiatric Association.
• Psychotherapy begins to help an individual be realistic about work
and relationships; to define and alleviate conflicts that may have
undermined a stable lifestyle; and to attempt to create a stable
lifestyle; and to find a comfortable way to live within a new gender
role and body.
• Real-life experience involves a clinician's assessment of whether
a person is thriving in the new gender role, including the ability
to maintain full or part-time employment and/or function as a
student and/or volunteer; acquire a new (legal) first or last name;
provide documentation that people other than the therapist know that
the patient functions in the new gender role.
• Hormonal therapy is approved if a person is 18 or older, in most
cases; clearly understands the risks of hormone therapy; spends at
least three months living in the new gender role and/or undergoes a
minimum of three months of psychotherapy.
• Surgical therapy -- sex reassignment surgery -- is approved only
after an individual has completed at least 12 months of hormonal
therapy, 12 months of successful real-life experience in the new
gender role, progress in dealing with interpersonal relationships
and progress in consolidating the new gender identity. For a variety
of reasons, including cost, not all transgender individuals seek
surgery. For those who do, fewer than 2 percent express regret about
the surgery.
Hormone therapy
The effects of hormones, some of which become irreversible after six
to nine months.
• Males taking female hormones and anti-hormones (which block
hormones already manufactured by the body): decrease in sperm count,
increase in breast size, redistribution of fat, creating a more
typical female shape, slowing of body hair growth. Some people
report feeling less anxious and an increased feeling of overall well-
being.
• The risks: Estrogens delivered orally can strain the liver;
susceptibility to blood clots, inflammation of lower extremity and
pelvic veins, varicose veins and elevated blood pressure; prostate
cancer risk decreases but breast cancer risk increases.
• Females taking male hormones: decrease in fertility, irregular
menstrual cycle that eventually stops and fat redistribution that
creates a more typically male shape. Male pattern baldness can set
in, hair growth on the body and face increases, and the clitoris may
elongate. Some people report an increase in aggression and dominant
feelings. Vocal chords thicken, deepening the voice. Taking male
hormones does not eliminate the breasts.
The risks: An increased risk of arterial hardening (particularly in
the heart) because of increased serum cholesterol levels; hormones
can stimulate liver tumors and cysts; breast cancer risk drops to
that of genetic males.
Sources: The World Professional Association for Transgender Health,
the International Journal of Transgenderism,
sexuality.org/ tsroadmap. com
Standards of Care help transgendered
By Angie Fenton
afenton@courier- journal.com
The Courier-Journal
Most reputable therapists and medical doctors who work with
transgender individuals follow the Harry Benjamin Standards of Care,
developed by the late physician, who was one of the first to work
with transgender people.
The goal of the standards is to provide "lasting personal comfort
with the gendered self in order to maximize overall psychological
well-being and self-fulfillment. "
Not all transgender individuals seek professional help. But for
those who do, a timeline might look something like this:
The Standards of Care process
• Personal recognition by an individual that he or she is "living a
lie," as many transgender people describe the experience of feeling
that the gender they were assigned at birth is incorrect.
• A mental health professional diagnoses an individual as suffering
from a genetic identity disorder as laid out in "The Diagnostic and
Statistical Manual of Mental Disorders," published by the American
Psychiatric Association.
• Psychotherapy begins to help an individual be realistic about work
and relationships; to define and alleviate conflicts that may have
undermined a stable lifestyle; and to attempt to create a stable
lifestyle; and to find a comfortable way to live within a new gender
role and body.
• Real-life experience involves a clinician's assessment of whether
a person is thriving in the new gender role, including the ability
to maintain full or part-time employment and/or function as a
student and/or volunteer; acquire a new (legal) first or last name;
provide documentation that people other than the therapist know that
the patient functions in the new gender role.
• Hormonal therapy is approved if a person is 18 or older, in most
cases; clearly understands the risks of hormone therapy; spends at
least three months living in the new gender role and/or undergoes a
minimum of three months of psychotherapy.
• Surgical therapy -- sex reassignment surgery -- is approved only
after an individual has completed at least 12 months of hormonal
therapy, 12 months of successful real-life experience in the new
gender role, progress in dealing with interpersonal relationships
and progress in consolidating the new gender identity. For a variety
of reasons, including cost, not all transgender individuals seek
surgery. For those who do, fewer than 2 percent express regret about
the surgery.
Hormone therapy
The effects of hormones, some of which become irreversible after six
to nine months.
• Males taking female hormones and anti-hormones (which block
hormones already manufactured by the body): decrease in sperm count,
increase in breast size, redistribution of fat, creating a more
typical female shape, slowing of body hair growth. Some people
report feeling less anxious and an increased feeling of overall well-
being.
• The risks: Estrogens delivered orally can strain the liver;
susceptibility to blood clots, inflammation of lower extremity and
pelvic veins, varicose veins and elevated blood pressure; prostate
cancer risk decreases but breast cancer risk increases.
• Females taking male hormones: decrease in fertility, irregular
menstrual cycle that eventually stops and fat redistribution that
creates a more typically male shape. Male pattern baldness can set
in, hair growth on the body and face increases, and the clitoris may
elongate. Some people report an increase in aggression and dominant
feelings. Vocal chords thicken, deepening the voice. Taking male
hormones does not eliminate the breasts.
The risks: An increased risk of arterial hardening (particularly in
the heart) because of increased serum cholesterol levels; hormones
can stimulate liver tumors and cysts; breast cancer risk drops to
that of genetic males.
Sources: The World Professional Association for Transgender Health,
the International Journal of Transgenderism,
sexuality.org/ tsroadmap. com