Patients with transsexualism need to adapt the body to the opposite biological sex, to which they themselves belong. Hormone therapy plays an important role in this.

Moreover, if before the operation you can still do without hormone therapy (although it is better to start it at least 6 months before the operation, which makes it easier for the postoperative period and precludes the development of a severe structural condition), after the operation, which includes As a rule, carrying out gonadectomy, it becomes absolutely necessary, because besides maintaining sexual status (libido, secondary sexual characteristics), it also performs a number of important functions (Table Y).

At present, there is an international transgender professional assistance organization, the Harry Benjamin International Gender Disorders Association, which has developed the Standards for the Care of Sexual Identity Disorders (6th version). Doctors around the world who examine and treat people with gender identity disorders work in accordance with these standards, whose main goal is to achieve professional consensus among psychiatrists, therapists, endocrinologists, and surgeons. In Russia, an analogue of this document is Order No. 311 of the Ministry of Health of the Russian Federation dated August 6, 1999 on approving the clinical guidelines Model of Diagnosis and Treatment of Mental and Behavioral Disorders, which also contains information on the prevalence of this phenomenon, recommendations on the formulation of diagnosis, basic diagnostics, treatment and monitoring of people with various types of violations of sexual autoidentification.

In particular, according to the developed standards, there are certain requirements that every endocrinologist must adhere to before starting hormone therapy in transgender patients: you must make sure that the patient is 18 years old, inform the patient about what results can be achieved with hormone therapy , and what – it is impossible; explain the disadvantages and advantages of the prescribed treatment, explain what changes will occur to the patient during the treatment. If necessary, issue a certificate stating the diagnosis and explaining what changes are taking place and for what reason with this patient. As a rule, the beginning of hormonal therapy in these patients coincides with the beginning of the so-called “real life test”, during which they try to live and adapt in a new biological field, and such information may be useful for resolving various misunderstandings, including related to the discrepancy of the passport floor before its change and appearance.

In addition, the “Standards for providing medical care for violations of gender identity” recommends obtaining the patient’s written consent to undergo treatment with hormonal drugs, reflecting a discussion of the problem of the risks and benefits of hormonal therapy.

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