Im falschen Körper geboren? Medizinische Aspekte der Transgendermedizin

Background: Gender incongruence is defined as discordance between a person's gender identity and their birth-assigned sex. One important part of the treatment of gender incongruence is gender-affirming hormone therapy, which aims to suppress secondary sex characteristics of the birth-assigned sex and to induce as well as maintain secondary sex characteristics in accordance with gender identity. Objective: Which drugs are used for gender-affirming hormone therapy and which effects, side effects, and long-term risks should be expected? Materials and methods The guidelines of the Endocrine Society, the World Professional Association for Transgender Health, and the American Society of Reproductive Medicine as well as clinical trials evaluating the long-term risks of gender-affirming hormone therapy are discussed. Results: Gender-affirming hormone therapy has a beneficial impact on mental health and the quality of life of transgender people. One long-term risk appears to be an increase in mortality due to cardiovascular diseases observed in transwomen in comparison to the general population. This increased mortality is not observed in transmen. Conclusion: Providing adequate information about effects, side effects, and long-term risks of gender-affirming hormone therapy is crucial to obtaining informed consent. In addition, transgender people must be informed about the effect of gender-affirming treatment on reproduction, and reproductive options must be explored with the individual prior to initiation of treatment.