跨性别女性性别确认激素治疗策略

跨性别女性是生理性别为男性,但持久而强烈地渴望自己的社会性别为女性,并存在可能因性别问题而感到不安的性别焦虑。无论是否进行性别重置手术,跨性别者的性别确认激素治疗可以改变他们的外貌,进而匹配他们的社会性别,来减轻性别焦虑。然而,此前我国跨性别者的诊治主要在精神心理科及整形外科进行,缺乏生殖内分泌专家的参与,跨性别女性性别确认激素治疗相关的专家共识及指南性文献在我国仍然空白。本文对已发表的关于跨性别女性性别确认激素治疗文献及现有指南进行了综述,包含治疗原则、药物选择、用法用量、相关副作用、用药后监测及对成人和青少年的具体治疗策略建议,以期为跨性别健康专业诊疗人员提供诊疗规范。

Transgender women are biologically male but have a persistent and intense desire to identify as female,as well as gender dysphoria that may make them uncomfortable with gender issues.Whether transsexual surgery is performed or not,gender⁃affirming hormone therapy for transgender people can change their appearance,and then match their gender to reduce gender dysphoria.However Previously,the diagnosis and treatment of transgender women in China were carried out in the department of psychiatry and the department of plastic and cosmetic surgery,lacking the participation of reproductive endocrinology experts.The expert consensus and guiding literature related to gender⁃affirming hormone therapy for transgender women are still rare in China.This paper reviews the published literature and existing guidelines,including treatment principles,drug selection,usage and dosage,related side effects,post medication monitoring,and specific treatment strategy recommendations for adults and adolescents,in order to provide diagnostic and therapeutic strategy for transgender health professionals.